Specialty intelligence

Hospice Reimbursement Alerts

Daily CMS policy updates, MAC LCD revisions, and coding guidance for Hospice billing teams. All alerts sourced directly from CMS, MAC contractor sites, and the Federal Register.

Critical alerts active

Total alerts

5

Average signal

79/100

Sources monitored

15+

Latest Hospice alerts

5

Federal Register Final Rule: Medicare Program; FY 2024 Hospice Wage Index and Payment Rate Update, Hospice Conditions of Participation Updates, Hospice Quality Reporting Program Requirements, and Hospice Certifying Physician Provider Enrollment Requirements

Hospice · Effective 2023-10-01

Federal Register Proposed Rule: Medicare Program; FY 2027 Hospice Wage Index and Payment Rate Update and Hospice Quality Reporting Program Requirements

Hospice

Federal Register Proposed Rule: Medicare Program; FY 2025 Hospice Wage Index and Payment Rate Update, Hospice Conditions of Participation Updates, and Hospice Quality Reporting Program Requirements

Hospice

What is Hospice reimbursement leakage costing you?

Calculate your ROI with Hospice-specific CMS benchmarks pre-populated.

Calculate ROI →

MAC contractor coverage

Hospice billing is subject to both national CMS policy and regional MAC contractor Local Coverage Determinations (LCDs). CLV Intelligence monitors all MAC contractor sites — Noridian, CGS, First Coast, NGS, Novitas, Palmetto GBA, and WPS — for LCD updates affecting Hospice codes. Coverage criteria vary by contractor jurisdiction.

NoridianCGS AdministratorsFirst CoastNational Government ServicesNovitas SolutionsPalmetto GBAWPS

Get Hospice alerts by email — free

Weekly digest of CMS and MAC policy changes for Hospice billing teams.

Frequently asked questions

What MAC contractors issue LCDs for Hospice billing?

Hospice billing is subject to regional Local Coverage Determinations (LCDs) from all seven Medicare Administrative Contractors: Noridian, CGS Administrators, First Coast Service Options, National Government Services, Novitas Solutions, Palmetto GBA, and WPS Government Health Administrators. Coverage criteria and medical necessity requirements vary by contractor jurisdiction. CLV Intelligence monitors all MAC contractor sites daily for LCD updates affecting Hospice codes.

How often does CMS update Hospice reimbursement policy?

CMS updates the Physician Fee Schedule annually, effective January 1, with proposed rules published in the summer and final rules in November. MAC contractors issue LCD updates on a rolling basis throughout the year with no fixed schedule. The Federal Register publishes proposed and final rules affecting Hospice reimbursement on a continuous basis. CLV Intelligence monitors all three sources daily and surfaces updates by signal strength.

What is a Local Coverage Determination (LCD) and how does it affect Hospice billing?

A Local Coverage Determination (LCD) is a decision by a Medicare Administrative Contractor specifying under what clinical circumstances a particular service is covered within its geographic jurisdiction. For Hospice billing teams, LCDs define medical necessity criteria, covered diagnoses, and documentation requirements for specific procedures. Failure to comply with LCD requirements is among the most common causes of Medicare claim denial in Hospice practices.

Reimbursement guides & resources

Plain-language guides to the policy cycles that drive Hospice reimbursement — the fee schedule, ICD-10, HCPCS, and Local Coverage Determinations.

Other specialties