Primary Source Documents
Every module in this course is built from these primary authorities. When interpretations differ or regulations are updated, the primary sources govern.
Code of Federal Regulations
42 CFR- 42 CFR Part 418 - Hospice Care
Full hospice conditions of participation and payment conditions, including Subparts B, C, and D.
- 42 CFR 418.20 - Eligibility Requirements
Medicare Part A entitlement and terminal illness eligibility.
- 42 CFR 418.22 - Certification of Terminal Illness
Certification timing, content, narrative, F2F requirements.
- 42 CFR 418.24 - Election of Hospice Care
Election statement, addendum, NOE filing requirements.
- 42 CFR 418.52 - Patient Rights
Notice of rights before furnishing care; required content.
- 42 CFR 418.54 - Nursing Services Assessment
Initial and comprehensive assessment requirements and timelines.
- 42 CFR 418.56 - IDG and Plan of Care
IDG composition, POC development, and review cadence.
- 42 CFR 418.104 - Clinical Records
Required clinical record content and authentication requirements.
Medicare Benefit Policy Manual
MBPM- Pub. 100-02, Chapter 9 - Coverage of Hospice Services
Operationalizes eligibility, certification, election, coverage criteria, and clinical record requirements.
Medicare Claims Processing Manual
Claims Manual- Pub. 100-04, Chapter 11 - Processing Hospice Claims
NOE timely filing rules, provider-liable day calculations, exception categories, and billing mechanics.
CMS Survey & Certification
S&C- SOM Pub. 100-07, Appendix M - Hospice Interpretive Guidelines
L-tag survey guidance for all hospice CoPs. Contains interpretive guidance behind every citation including L522, L523, L524, L525, L530–L537, L538, L543, L544, L673–L676.
- QSO-23-08 - Hospice Survey Revisions (January 6, 2023)
CMS survey operational memo that shifted hospice surveys to a quality-of-care investigative approach, with Phase I CoP emphasis.
MLN Matters Change Requests
MLN- MM12015 - Hospice Election Statement Changes (FY 2020 Final Rule)
Implements Oct 1, 2020 required election statement changes: cost-sharing disclosure, BFCC-QIO information, and election statement addendum.
- MM12491 - Hospice Election Statement Addendum Clarifications
Additional guidance on the patient notification addendum for non-covered items, services, and drugs.
CMS Hospice Center
CMS- CMS Hospice Center
Central CMS resource for hospice providers - final rules, transmittals, manual chapters, and current guidance updates.
- FY 2026 Hospice Final Rule
Restores signature-date requirement for F2F attestations; includes updated payment rates and quality reporting changes.
Note: Regulatory citations and manual chapter references are current as of the FY 2026 Hospice Final Rule. CMS updates manual chapters through numbered transmittals without notice. Always verify chapter and section numbers against the current version on the CMS website before citing in compliance documentation or legal proceedings.