Implement Edits on Hospice Claims
The purpose of this Change Request (CR) is to implement edits on Hospice Claims. Any hospice claim with an attending or rendering National Provider Identifier (NPI), they have to be enrolled in Medicare as part of a new rule that is coming as of May 1st, 2024. The hospice physician and attending physician need to be enrolled/opted-out at the time they make the certification or recertification of hospice care for a patient. The Provider Enrollment Chain and Ownership System (PECOS) will create a new extract file and send it to the Fiscal Intermediary Shared System (FISS). PECOS will send a list of NPIs that are eligible for certifying that beneficiary for Hospice care.
Final
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: October 26, 2023
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