- Hospice Levels of Care: Routine Home Care
- Documenting the Face-to-Face Encounter and Attestation
- Hospice Levels of Care: Inpatient Respite Care
- Hospice Documentation Checklist
- Hospice Documentation Tips
- Implementation of the Election Statement Addendum
- Hospice Beneficiary Election Statement Addendum Frequently Asked Questions
- Hospice Levels of Care: General Inpatient Care
- Documentation for Hospice Transfers
- Tips for Responding to a Hospice ADR
- Documentation Requirements for the Medicare Hospice Election Statement
- Documentation Requirements for the Hospice Physician Certification/Recertification
- Hospice Levels of Care: Continuous Home Care
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