Hospice

A Medicare patient may be eligible to receive home health care for a condition not related to their terminal illness if the home health benefit criteria are met. The home health agency will bill their services to Medicare by including condition code 07, treatment of non-terminal condition for hospice patient, on their claim.

Last Reviewed: 08/07/2026

If an invalid revocation or revocation date is submitted on the discharge claim, the provider may adjust the claim to correct the revocation status or date of revocation. If the discharge claim is submitted with a 01 patient status code, 42 occurrence code and date, then the patient's hospice services are revoked.

To remove an invalid hospice revocation date submitted on the discharge claim, the provider should submit an adjustment bill (TOB 8X7) with a corrected patient status code and delete the 42 occurrence code on the claim. Providers may also adjust the discharge bill to correct the 42 occurrence code date.

To correct an invalid hospice revocation date submitted on the discharge claim, the provider should submit an adjustment bill (TOB 8X7) with corrected dates of service (DOS) with Claim Change Reason Code D0.

If an invalid revocation date is submitted on a Notice of Termination/Revocation TOB 8XB), it may be corrected (page 5) or removed (page 6) by using the instructions in the Notice of Termination/Revocation TOB 8XB Job Aid (PDF).

Please note: Providers should examine Palmetto GBA’s eServices or any Medicare beneficiary eligibility system for any irregularities. If the hospice periods are accurately recorded, providers may adjust the claim. If the hospice periods have inaccurate information (i.e., days used or earliest or latest billing dates) providers should call the provider contact center for assistance.

Last Reviewed: 08/07/2026

Hospice agencies must submit the patient signed election form along with all other requested records. If this form is not submitted, there is a possibility of the claim being denied by Medical Review.

Last Reviewed: 08/07/2026

These are questions and responses about the Hospice Beneficiary Election Statement Addendum (PDF).

Last Reviewed: 08/07/2026

CHC visits are counted in the same manner as routine home care (RHC) visits.

References

• For dates of service prior to January 1, 2010, see CR 5567 (PDF)
• For dates of service on or after January 1, 2010, see CR 6440 (PDF)

Last Reviewed: 08/07/2026

Answer
Palmetto GBA will follow the signature guidelines from CMS and will continue to accept electronic signatures if they are still scribed (handwritten) by the beneficiary or representative, in ink or on a device (tablet, etc.).

Last Reviewed: 08/07/2026

Background
A hospice patient has accessed their Medicaid benefits on admission to hospice. The patient was retroactively enrolled in Medicare and does not notify the hospice of their Medicare entitlement. The hospice did not have the beneficiary initially sign the election statement until the agency discovered that the beneficiary is entitled to Medicare.

Answer
The Medicare hospice benefit cannot begin until the beneficiary signs the election statement. In cases where a beneficiary’s care begins prior to Medicare entitlement, a beneficiary must sign a Medicare Hospice election statement designating the effective date for Medicare hospice care to begin. The election statement cannot be back dated. Therefore, any care provided to a beneficiary prior to the date the actual election statement is signed is not billable to Medicare.

As a reminder, providers are responsible for ensuring that they check a patient’s Medicare eligibility upon admission and periodically throughout the time in which they are providing care.

Last Reviewed: 08/07/2026