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License for Use of "Physicians' Current Procedural Terminology", (CPT) Fourth Edition

End User/Point and Click Agreement: CPT codes, descriptions and other data only are copyright 2009 American Medical Association (AMA). All Rights Reserved (or such other date of publication of CPT). CPT is a trademark of the AMA.

You, your employees and agents are authorized to use CPT only as contained in the following authorized materials including but not limited to CGS fee schedules, general communications, Medicare Bulletin, and related materials internally within your organization within the United States for the sole use by yourself, employees, and agents. Use is limited to use in Medicare, Medicaid, or other programs administered by the Centers for Medicare & Medicaid Services (CMS). You agree to take all necessary steps to insure that your employees and agents abide by the terms of this agreement.

Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CPT for resale and/or license, transferring copies of CPT to any party not bound by this agreement, creating any modified or derivative work of CPT, or making any commercial use of CPT. License to use CPT for any use not authorized here in must be obtained through the AMA, CPT Intellectual Property Services, 515 N. State Street, Chicago, IL 60610. Applications are available at the AMA websiteExternal Website.

This product includes CPT which is commercial technical data and/or computer data bases and/or commercial computer software and/or commercial computer software documentation, as applicable which were developed exclusively at private expense by the American Medical Association, 515 North State Street, Chicago, Illinois, 60610. U.S. Government rights to use, modify, reproduce, release, perform, display, or disclose these technical data and/or computer data bases and/or computer software and/or computer software documentation are subject to the limited rights restrictions of DFARS 252.227-7015(b)(2)(June 1995) and/or subject to the restrictions of DFARS 227.7202-1(a)(June 1995) and DFARS 227.7202-3(a)June 1995), as applicable for U.S. Department of Defense procurements and the limited rights restrictions of FAR 52.227-14 (June 1987) and/or subject to the restricted rights provisions of FAR 52.227-14 (June 1987) and FAR 52.227-19 (June 1987), as applicable, and any applicable agency FAR Supplements, for non-Department Federal procurements.

AMA Disclaimer of Warranties and Liabilities.

CPT is provided "as is" without warranty of any kind, either expressed or implied, including but not limited to, the implied warranties of merchantability and fitness for a particular purpose. AMA warrants that due to the nature of CPT, it does not manipulate or process dates, therefore there is no Year 2000 issue with CPT. AMA disclaims responsibility for any errors in CPT that may arise as a result of CPT being used in conjunction with any software and/or hardware system that is not Year 2000 compliant. No fee schedules, basic unit, relative values or related listings are included in CPT. The AMA does not directly or indirectly practice medicine or dispense medical services. The responsibility for the content of this file/product is with CGS or the CMS and no endorsement by the AMA is intended or implied. The AMA disclaims responsibility for any consequences or liability attributable to or related to any use, non-use, or interpretation of information contained or not contained in this file/product. This Agreement will terminate upon notice if you violate its terms. The AMA is a third party beneficiary to this Agreement.

CMS Disclaimer

The scope of this license is determined by the AMA, the copyright holder. Any questions pertaining to the license or use of the CPT must be addressed to the AMA. End Users do not act for or on behalf of the CMS. CMS DISCLAIMS RESPONSIBILITY FOR ANY LIABILITY ATTRIBUTABLE TO END USER USE OF THE CPT. CMS WILL NOT BE LIABLE FOR ANY CLAIMS ATTRIBUTABLE TO ANY ERRORS, OMISSIONS, OR OTHER INACCURACIES IN THE INFORMATION OR MATERIAL CONTAINED ON THIS PAGE. In no event shall CMS be liable for direct, indirect, special, incidental, or consequential damages arising out of the use of such information or material.

This license will terminate upon notice to you if you violate the terms of this license. The AMA is a third party beneficiary to this license.

POINT AND CLICK LICENSE FOR USE OF "CURRENT DENTAL TERMINOLOGY", ("CDT")

End User License Agreement

These materials contain Current Dental Terminology, Fourth Edition (CDT), copyright © 2002, 2004 American Dental Association (ADA). All rights reserved. CDT is a trademark of the ADA.

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  1. Subject to the terms and conditions contained in this Agreement, you, your employees, and agents are authorized to use CDT-4 only as contained in the following authorized materials and solely for internal use by yourself, employees and agents within your organization within the United States and its territories. Use of CDT-4 is limited to use in programs administered by Centers for Medicare & Medicaid Services (CMS). You agree to take all necessary steps to ensure that your employees and agents abide by the terms of this agreement. You acknowledge that the ADA holds all copyright, trademark and other rights in CDT-4. You shall not remove, alter, or obscure any ADA copyright notices or other proprietary rights notices included in the materials.
  2. Any use not authorized herein is prohibited, including by way of illustration and not by way of limitation, making copies of CDT-4 for resale and/or license, transferring copies of CDT-4 to any party not bound by this agreement, creating any modified or derivative work of CDT-4, or making any commercial use of CDT-4. License to use CDT-4 for any use not authorized herein must be obtained through the American Dental Association, 211 East Chicago Avenue, Chicago, IL 60611. Applications are available at the American Dental Association websiteExternal Website.
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  5. CMS DISCLAIMER. The scope of this license is determined by the ADA, the copyright holder. Any questions pertaining to the license or use of the CDT-4 should be addressed to the ADA. End users do not act for or on behalf of the CMS. CMS DISCLAIMS RESPONSIBILITY FOR ANY LIABILITY ATTRIBUTABLE TO END USER USE OF THE CDT-4. CMS WILL NOT BE LIABLE FOR ANY CLAIMS ATTRIBUTABLE TO ANY ERRORS, OMISSIONS, OR OTHER INACCURACIES IN THE INFORMATION OR MATERIAL COVERED BY THIS LICENSE. In no event shall CMS be liable for direct, indirect, special, incidental, or consequential damages arising out of the use of such information or material.

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Hospice Discharge, Revocation and Transfers

Medicare Benefit Policy Manual (CMS Pub. 100-02), Ch. 9, §20.2External PDF

The Medicare hospice benefit is only available to beneficiaries who are terminally ill. A hospice may discharge a beneficiary in certain situations. A beneficiary or representative may choose to revoke the election of hospice care at any time. In addition, a beneficiary may transfer hospice agencies only once in each benefit period. Select the topic below for additional information.

Discharge from Hospice

Medicare Benefit Policy Manual (CMS Pub. 100-02), Ch. 9, §20.2.3External PDF

The election of the hospice benefit is the beneficiary's choice rather than the hospice's choice, and thus, the hospice cannot revoke the beneficiary's election. Therefore, when a hospice agency admits a beneficiary to hospice, it may not automatically or routinely discharge the beneficiary at its discretion, even if the care promises to be costly or inconvenient.

Discharge from hospice care can occur as a result of the following:

  • The beneficiary decides to revoke the hospice benefit;
  • The beneficiary transfers to another hospice
  • The beneficiary dies;
  • The beneficiary moves out of the hospice's service area or transfers to another hospice;
  • The hospice determines the beneficiary is no longer terminally ill; or
  • The hospice determines the beneficiary meets their internal policy regarding discharge for cause.

When a patient is discharged from hospice care, the beneficiary:

  • Is no longer covered under the Medicare hospice benefit;
  • Resumes Medicare coverage of the benefits waived by their hospice election; and
  • May at any time, elect to receive hospice care if he/she is again eligible.

Hospices may bill for the day of discharge.

Revocation of the Election

A hospice revocation is a beneficiary's choice to no longer receive Medicare covered hospice benefits. To revoke the election of hospice care, the beneficiary/representative must give a signed written statement of revocation to the hospice. No standardized hospice revocation form exists.

  • The statement must contain the effective date of the revocation.
  • A verbal revocation of benefits is NOT acceptable.
  • The individual forfeits hospice coverage for any remaining days in that election period.
  • An individual may not designate a revocation effective date earlier than the date the revocation is made.
  • The day of revocation is a billable day.
  • The hospice cannot revoke the beneficiary's election, nor can the hospice demand the beneficiary revoke his/her election.

Upon revoking the election of Medicare coverage of hospice care for a particular election period, an individual resumes Medicare coverage of the benefits waiver when hospice care was elected. In cases where the individual was enrolled in a Medicare Advantage (MA) Plan at the time they elected hospice, all Medicare claims will continue to be paid by the fee-for-service contractor (A/B MAC) until the first day of the month following the revocation.

An individual may, at any time, re-elect to receive hospice coverage, provided that the beneficiary is otherwise entitled to hospice care benefits.

A revocation is the beneficiary's choice rather than the hospice's choice, and the hospice cannot revoke the beneficiary's election. In addition, the hospice cannot request nor demand the beneficiary revoke his/her election.

Refer to the Submitting a Hospice Notice of Termination/Revocation of ElectionPDF resource for billing information.

Transfer to Another Hospice

Medicare Benefit Policy Manual (CMS Pub. 100-02), Ch. 9, 20.2External PDF

An individual may change the designation of the hospice they receive care from only once in each election period.

  • The change of hospice is not considered a hospice revocation.
  • The beneficiary must file a signed statement with the hospice they have received care from and the newly designated hospice. The statement must include:
    • The name of the hospice the patient was receiving care from;
    • The name of the hospice that patient plans to receive care from; and
    • The date the change is effective.
  • The date of transfer is billable by both the discharging agency and the admitting agency.

A change of ownership is not considered a change in the beneficiary's designation of a hospice agency, and requires no action by the beneficiary.

Refer to the following resources for additional information.

Reviewed: 12.08.21

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