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MM13531 - Hospice Claims Edits for Certifying Physicians

This new Article comprises Subregulatory Guidance for these updates starting May 1, 2024:
• CMS will pay for hospice services if certifying physicians, including hospice physicians and hospice attending physicians, are enrolled in or opted-out of Medicare
• The hospice attending and certifying physicians will be subjected to ordering and referring denial edits

MLN Matters (MM) Articles are based on information contained within Change Requests (CRs). In this case, this article is based on content within CR13531 that is posted on the CMS website at

Download the Guidance Document


Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: April 18, 2024

DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.