- Medicare Hospice Quick Reference Sheet
- Hospice Certifying Physician Medicare Enrollment Information
- Hospice Claim Reporting Requirements for Attending and Certifying Physicians
- 17729 Hospice Claim Edit for Certifying Physicians
- Billing Hospice Transfers
- Hospice Notice of Election Termination/Revocation (Type of Bill 8xB)
- Hospice Room and Board Denials
- Professional Services During a Patient Hospice Election
- Incarcerated or Unlawfully Present in the U.S. Claim Rejections (U538H, U538Q)
- Counting 60-Day Election Periods
- Untimely Filed Notice of Election Circumstance Exception: Medicare Beneficiary Is Granted Retroactive Medicare Entitlement
- Hospice Billing Codes Chart
- Appropriate Use of Occurrence Code 27 and Occurrence Span Code 77
- Hospice Notice of Change of Ownership
- Filing an Electronic Notice of Change of Ownership (TOB 8XE)
- Hospice Change of Ownership
- Filing an Electronic Notice of Cancelation (Type of Bill 8XD)
- Filing an Electronic Notice of Transfer (Type of Bill 8XC)
- Counting 60-Day Election Periods - Leap Year
- Hospice Site of Service Codes
- Billing Hospice Physician, Nurse Practitioner and Physician Assistant Services (Related To Terminal Diagnosis)
- Hospice Visit Reporting
- The Medicare Hospice Benefit: Effects on Other Provider Types
- Counting 90-Day Election Periods - Leap Year
- Reporting Hospice Discharges, Revocations and Transfers
- Avoiding Reason Code 7C625: Appropriate Use of Remarks on Final Hospice Claims
- Hospice Claim Submission Job Aid
- Counting 90-Day Election Periods
- Hospice Quality Reporting Program
- Filing an Electronic Notice of Election (Type of Bill 8XA)
- Value-Based Insurance Design Model Hospice Benefit Component Overview
- Documentation for Hospice Transfers
- Hospice Billing Instructions for Influenza, Pneumococcal and Hepatitis B Vaccines
- Canceling a Hospice Notice of Election
- How to Bill When the Hospice Face-to-Face is Late from a Previous Benefit Period
- Billing Medicare for a Denial - Condition Code 21
- Reminder on Deleting Revenue Code Line(s) in the Fiscal Intermediary Standard System Direct Data Entry System
Documentation for Hospice Transfers
The purpose of a hospice transfer is to allow the beneficiary the opportunity to switch agencies without affecting their benefit period in an effort to provide continuity of care. Instead of the beneficiary or their representative revoking the hospice benefit, or the transferring hospice agency discharging the patient causing the receiving hospice agency to complete a new admission, CMS allows the beneficiary to simply transfer care to another hospice agency. The focus of a hospice transfer is the beneficiary and ensuring a smooth transition to the receiving agency.
When a beneficiary or their representative elects to utilize the Medicare hospice benefit, an election statement must be filed with a hospice agency of their choice. Once in each election period the beneficiary or their representative may transfer their care from one hospice agency to another.
To transfer to another hospice agency, the beneficiary or their representative must file a statement or transfer agreement that includes the following information:
- The name of the hospice agency from which the beneficiary has been receiving care and the name of the new hospice agency from which the beneficiary intends to continue care.
- The date the transfer is to be effective.
- The signature of the beneficiary or their representative.
When a hospice transfer occurs, the benefit period dates are not affected. However, the receiving hospice must file a new Notice of Election and complete all assessments required by the hospice conditions of participation as described in 42 CFR 418.54.
It is expected that one of the two hospice agencies will assist the beneficiary or their representative with the completion of the transfer agreement. A beneficiary transfer agreement must be filed with both the transferring and receiving agencies. Both hospice agencies require a copy of the signed transfer agreement. The transferring and receiving hospice agencies should collaborate and agree upon the date of transfer which should be the same day as each is permitted to bill for the day of transfer. (For more billing information regarding transfers, see the Hospice Transfers Job Aid).
CMS and NGS expect all hospice agencies work collaboratively to resolve any disputes regarding beneficiary transfers in an effort to ensure a smooth transition of care and billing practices. If a dispute cannot be resolved NGS is available to assist.
Did You Know?
When a hospice transfer occurs in the beneficiary’s third or later benefit period, the transferring hospice agency will need to provide documentation of the face-to-face encounter to the receiving hospice agency.
A change of ownership of a hospice is not considered a change in the patient’s designation of a hospice and requires no action on the patient’s part.
More information on the face-to-face encounter requirements can be found in the CMS Internet Only Manual (IOM) Publication 100-02, Medicare Benefit Policy Manual, Chapter 9.
Revised 1/13/2023