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Physician Services

Medicare Benefit Policy Manual (CMS Pub. 100-02) Ch. 9 § 40.1.3External PDF

CGS "Billing Hospice Physician and Nurse Practitioner (NP) ServicesPDF" quick resource tool

Physicians are instrumental in directing the beneficiary's plan of care (POC) and hospice services. The medical director or physician from the Interdisciplinary Group (IDG) must be a doctor of medicine (MD) or osteopathy (DO). The beneficiary may choose an attending physician, who can be an MD, DO or nurse practitioner (NP). However, an NP cannot sign certifications of terminal illness. For more information about NPs as attending physicians, refer to the Medicare Benefit Policy Manual (CMS Pub. 100-02) Ch. 9 § PDF

The beneficiary may see the hospice physician, or their attending physician for their terminal illness. Visits to other physicians for symptoms related to the terminal illness must be planned through the hospice agency to be paid. The beneficiary may continue to seek healthcare for issues other than their terminal illness, under traditional Medicare. The beneficiary should be instructed to communicate these visits with their hospice to aid in care planning.

Reviewed: 12.08.21


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