Search Frequenty Asked Questions

Hospice Information Resource
for Medicare

Hospice is a special way of caring for people who are terminally ill, and for their families. This care includes physical care and counseling. Hospice care is given by a public agency or private company approved by Medicare. It is for all age groups, including children, adults, and the elderly during their final stages of life. The goal of hospice is to care for the patients and their families, not to cure their illnesses.

Highlights

Stay Informed - Go to CMS Mailing Lists to join a provider specific listserv (or electronic mailing list service) to receive news from CMS.

Billing/Payment

Hospice Wage Index FY 2005: Notice(issued August 27, 2004)(PDF file - 98 kb)

Hospice Wage Index FY 2004: Notice (issued September 30, 2003) (PDF file - 1.1 mb)

Hospice Wage Index FY 2003: Notice (issued August 30, 2002) (PDF file - 98 kb)

Hospice Wage Index FY 2002: Correction Notice (issued October 12, 2001) (PDF file - 15 kb)

Hospice Wage Index FY 2002: Notice (issued September 27, 2001) (PDF file - 166kb)

Electronic Data Interchange (EDI)(Billing)- Medicare information on electronic transactions under HIPAA

Managed Care

CMS Manuals and Transmittals

• CMS Manual System (Internet-Only Manuals) -- Effective October 1, 2003, CMS transitioned from a paper-based to a web-based manual system.
• Hospice Program Transmittals
• Program Memoranda
• Hospice and Intermediary Manual -- Crosswalks from Paper-Based Manuals to Internet-Only Manuals

Provider Reimbursement Manual - Part II

Medicare National Coverage Determinations Manual

Enrollment/Participation/Certification

Enrollment

• CMS 855 Enrollment Form

Conditions of Participation

Certification and Recertification by Physicians for Hospice Care

• CMS 417 Certification Form (PDF file - 10 kb)

Survey and Certification

Survey and Certification Memoranda

Coding

Healthcare Common Procedure Coding System (HCPCS)

Alpha-Numeric HCPCS File

ICD9-CM Coordination and Maintenance Committee
This site includes links to the ICD-9 codes.

ICD-9-CM Diagnosis and Surgical Codes

ICD-9 Coding Resources on Medlearn Effective October 1, 2003

Policies/Regulations

Medicare Modernization Act

Quarterly Provider Update -- Hospice Regulations Published This Quarter

Reapproval of the Community Health Accreditation Program (CHAP) for Deeming Authority for Hospices: Final Notice (issued September 26, 2003) (PDF file - 45 kb)

Physician or NP/PA Payments, Eligibility, Advance Directives, Miscellaneous Issues

CMS-1727-P Medicare Program; "Provider Reimbursement Determinations and Appeals"

• CMS-1727-P, (adobe pdf 319Kb) Published at the Office of the Federal Register June 25, 2004
• CMS-1727-P (Microsoft Word zipped 114Kb) On Display June 24, 2004

Health Insurance Portability and Accountability Act (HIPAA)

• CMS-0045-F - HIPAA Administrative Simplification: Standard Unique Health Identifier for Health Care Providers

Coverage

Medicare Coverage Homepage

Medicare Coverage Database contains National Coverage Determination(NCDs), National Coverage Analyses(NCAs), and Local Medical Review Policy (LMRPs)

Medicare National Coverage Determinations Manual

Medicare Secondary Payer

Medicare Secondary Payer Manual

Medicare Coordination of Benefits

Program Integrity/Medical Review

Fighting Fraud and Abuse

Medicare Medical Review Program

Medicare Integrity Program

Education

Hospice Care Enhances Dignity and Peace As Life Nears Its End - Educational Article (PDF file - 102 mb)

Medlearn

• Medlearn Matters...Information for Medicare Providers -- Articles are designed to help providers understand new or changed Medicare policy.

Frequently Asked Questions

Research and Statistics

Medicare Hospice Utilization by State CY 2000 (PDF file - 48 mb)

Hospice Data - FY 1991 through FY 2001 (zip file - 5kb)

How to Stay Informed

The CMS Quarterly Provider Update

• Hospice Quarterly Provider Update

Go to CMS Mailing Lists to join a the Hospice listserv (or electronic mailing list service) to receive news from CMS.

Open Door Forum: Home Health, Hospice, and Durable Medical Equipment

Press Releases: CMS Media Release Search

Contacts

Contact Your Carrier/FI
via Toll-Free Numbers and Websites -- A listing of the new toll free numbers that CMS has installed at Medicare contractor sites

• Regional Home Health Intermediary (RHHI)

CMS Regional Office Contacts

Resources

End of Life Planning Information Guide

• Why is Planning Important?
• How to Get Started on Making These Decisions
• End of Life Planning Guide Examples

Hospice Resources and References

• Organization Websites
• Books
• Glossary
• Questions on Hospice