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February 19, 2019

Hospice Notice of Termination/Revocation (NOTR) – 8XB Billing Reminders

This article serves as a reminder for hospice providers of when it is appropriate to submit a notice of termination/revocation (type of bill 8XB). CGS often sees that hospice providers incorrectly submit NOTRs in situations where the patient actually transferred to another hospice. This can cause extra work for hospices. Hospice billing staff should review the following information to ensure NOTRs are submitted appropriately.


The NOTR is submitted when the hospice discharges the beneficiary or the beneficiary chooses to revoke the Medicare Hospice Benefit if the hospice has not already filed a final claim. The NOTR or final claim (8X4) must be filed within five days of the effective date the beneficiary is discharged or revoked. Refer to the following CGS resources:

When an NOTR is submitted, a revocation date is posted to the Common Working File (CWF). If the NOTR was submitted entirely in error (e.g., the beneficiary actually transferred to another hospice, rather than revoking the hospice benefit), the hospice will need to:

  • Cancel any claims processed in the benefit period;
  • Remove the election period by submitting a notice of cancelation (8XD) to remove the revocation date; and
  • Resubmit the corrected information.

Transfer Notice of Election – 8XC

When a beneficiary chooses to transfer from one hospice agency to another, the hospice agency that the beneficiary is transferring from submits a final claim (8X1 or 8X4). After the transferring hospice has submitted their final claim, the admitting hospice then submits a transfer Notice of Election (type of bill 8XC). CGS offers the following resources to ensure proper billing.

Please refer to the above resources to ensure proper billing.

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