Check out these disease-specific guidance documents, among other materials.>
Hospices can use all the help they can get defending their claims from terminal illness-related denials.
Take advantage of these free tools from HHH Medicare Administrative Contractors National Government Services, Palmetto GBA, and CGS to help bulletproof your reimbursement.
From NGS:
- Documentation Requirements for the Hospice Physician Certification/Recertification .
- Medicare Monthly Review Details: Hospice Certification and Recertification
- Hospice Documentation Checklist .

From Palmetto:
- Hospice Certification of Terminal Illness webpage .
- CTI learning module .
- Hospice Medical Necessity Tips for Medical Record Review .
From CGS:
- Hospice Certification/Recertification Requirements webpage .
- Hospice Denial Fact Sheet for Denial Reason 5PM01: Six-Month Terminal Prognosis Not Supported .
- Suggestions for Improved Documentation to Support Medicare Hospice Services .
- Quick Resource Tools for Hospice Terminal Prognoses for nine disease categories — links under “Clinical” at .