2019 Redesign of Hospice Periods

CR 10967 provides excellent news for Hospice Providers – there is no new policy, simply revisions to help Hospices with processing issues stemming from the new design of hospice periods in Medicare’s CWF.

Effective April 1, 2019, MACs will allow hospice providers to submit zeroes in the Through date of Notices of Termination/Revocation (NOTR – TOB 8xB) when occurrence code 56 and condition code D0 are present when the NOTR is entered via Direct Data Entry (DDE).  PLEASE NOTE: Zeros in the Through date are not allowed in the 837I transaction.

With this CR, MACs will allow hospices to fix incorrect election or revocation dates using occurrence code 56 and condition code D0 on transfer notices (TOB 8xC) or change of ownership notices (8xE). MACs will return the TOB 8xC or 8xE to the provider if:

  • Condition code D0 is present, but occurrence code 56 is not, or
  • Occurrence code 56 is present, but condition code D0 is not.

See the full details on these changes here.

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