As finalized in the FY2024 Hospice Payment Rate Update Final Rule, physicians who certify hospice services must enroll in or opt-out of Medicare. Originally, the implementation of this provision was set for May 1, 2024. Due to technical issues hospices were facing confirming that physicians were indeed enrolled or formally opted out, CMS delayed the implementation until June 3, 2024. At that time, CMS will begin denying hospice claims if the certifying physician, including hospice physician and hospice attending physician, is not in PECOS hospice ordering and referring files. CMS created a Hospice Certifying Enrollment Q&A clarifying the requirements. An additional MLN Matters Article summarizes the changes Hospice Claims Edits for Certifying Physicians.
Certifying Physician Enrollment or Opt-Out Delayed until June 3
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