Skip to Main Content

Print | Bookmark | Email | Font Size: + |

Hospice Levels of Care

Medicare Benefit Policy Manual (CMS Pub. 100-02) Ch. 9 §40.1.5, 40.2.1, and 40.2.2External PDF

Medicare Claims Processing Manual (CMS Pub. 100-04) Ch. 11 §30.1External PDF

Most hospice care is considered “routine care”, and is provided to the beneficiary in their home, in accordance with the beneficiary's needs. However, there are times while under hospice care, that the beneficiary needs additional services, and the Medicare hospice benefit allows for these needs by providing additional levels of care. When a beneficiary needs additional services, or another level of care, it should be clear in the documentation what precipitated the change, and any attempts to maintain the beneficiary in routine care prior to the change.

There are four hospice levels of care. Routine home care is billed when none of the other levels of care is appropriate. Click on the following links to learn more about each level of care, and the requirements for that level of care to be billed to Medicare.

Reviewed: 12.08.21


26 Century Blvd Ste ST610, Nashville, TN 37214-3685 © CGS Administrators, LLC. All Rights Reserved