Hospice Claims Filing
- Medicare Claims Processing Manual (Pub. 100-04), Chapter 11
- Medicare Claims Processing Manual (Pub. 100-04), Chapter 25
The Medicare hospice benefit requires providers to submit a Notice of Election (NOE) and a claim. In some situations, a notice of a change of a hospice provider, or a Notice of Election Termination/Revocation (NOTR) also needs to be submitted. The following information provides guidance on how to enter these billing transactions in the Fiscal Intermediary Standard System (FISS) Claims/Attachments option (FISS Main Menu option 02) via Direct Data Entry (DDE). For more detailed information about FISS, refer to the Chapters 1-5 of the FISS Guide. You may also submit NOEs via Electronic Data Interchange (EDI) effective with the January 2, 2018, implementation of Change Request (CR) 10064. Refer to CMS 837I NOE Companion Guide for the required elements.
Notice of Election
The NOE is submitted to notify the Medicare contractor, and the Common Working File (CWF), of the start date of the beneficiary's election to the hospice benefit. The NOE is submitted after the beneficiary has signed the election statement and is only submitted once. Hospices must submit the NOE within 5 calendar days after the hospice admission (refer to the Change Request 8877 CGS Web page for additional information). To be timely, the NOE must be submitted to, and accepted by, CGS. To be accepted by CGS, the NOE must be free of billing or keying errors that would cause the NOE to be returned or rejected.
Notice of Elections (NOEs)/Transfer NOE
If the NOE is submitted untimely, refer to the following resources:
- Submitting Claims for Untimely Notices of Election (NOEs) Web page
- Requesting an Exception for an Untimely NOE Web page
Additional Resource:
Hospice Claims
Hospices claims must be billed sequentially. The first hospice claim for a beneficiary may be submitted only after the NOE has processed (P B9997). After the first claim processes (pays, denies or rejects), the subsequent claim can then be submitted. Due to sequential billing, hospice claims must be submitted monthly and processed in date order. In addition, only one claim is allowed per month, per beneficiary (except when the patient has been discharged/revoked, and re-elected hospice care). Review the Hospice Sequential Billing Web page for additional information.
Hospice Claims
Notice of Termination/Revocation (NOTR) – 8XB
Hospices are required to submit a Notice of Termination/Revocation (NOTR), also known as a type of bill (TOB) 8XB, within 5 calendar days after a hospice discharge/revocation, unless a final claim has already been submitted. For additional information, refer to the Change Request 8877 CGS Web page. You may also submit NOTRs via Electronic Data Interchange (EDI) effective with the January 2, 2018, implementation of Change Request (CR) 10064. Refer to CMS 837I NOE Companion Guide for the required elements.
Notice of Termination/Revocation (NOTR) – 8XB
- Claim Page 01
- Claim Page 03
- Claim Page 01 – Correcting a Notice of Termination/Revocation date – NOTR (8XB)
Additional Resource:
- Submitting a Hospice Notice of Termination/Revocation of Election TOB 8XB quick resource tool
Updated: 02.08.21