Hospice Claims Filing

The Medicare hospice benefit requires that providers submit two types of billing transactions; the Notice of Election (NOE) and the claim.  The NOE (an abbreviated claim) 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 first claim is submitted, only after the NOE has processed.  Before billing the first claim to Medicare, review the sequential billing requirements.  Hospice claims must be submitted and processed in date order.  After the first claim processes, the subsequent claim can then be submitted.  Claims must also be submitted monthly and should not span a two month period.  For example, claims for September and October must be submitted separately due to changes to reimbursement rates.  Claims for October and November must also be submitted separately due to the end of the hospice “cap period”.

The Fiscal Intermediary Standard System (FISS) Claims/Attachments option (FISS Main Menu option 02) allows you to enter NOEs and hospice claims.  The following provides screen prints and field descriptions for each of the six FISS claim pages and identifies which pages/fields are required for NOEs and hospice claims. For more detailed information about FISS, refer to the FISS Reference Guide.

Notice of Elections (NOEs)

Hospice Claims

Special Hospice Claims Filing Situations

Additional Resources

  • Medicare Claims Processing Manual Globe to indicate www link. (CMS Pub. 100-04, Ch. 11)—Chapter 11 of the Medicare Claims Processing Manual provides information about the Medicare hospice benefit including billing, payment, caps and limitations, and medical review of hospice claims.
  • Medicare Claims Processing Manual Globe to indicate www link. (CMS Pub. 100-04, Ch. 25)—Refer to Chapter 25 for a complete description of all the items included on the CMS-1450 (UB-04) claim form.
  • Hospice Quick Reference Tools—A variety of tools developed by the Cahaba’s Provider Outreach and Education staff are available to assist in the successful processing of your claims.

Page last updated: April 14, 2008

Curved image to open the content area