CMS Updates Hospice Claims Reporting Guidelines Effective April 1, 2025

The Centers for Medicare & Medicaid Services (CMS) has announced important updates to the MLN Matters Processing Hospice Claims – Principal Diagnosis Code Reporting, effective for hospice claims received on or after April 1, 2025. The revisions include new guidance on non-reportable principal diagnosis codes, clarifying the liability for claim denials during a hospice election, and the addition of related conditions to Chapter 11, Section 50 of the Medicare Claims Processing Manual.

For full details, refer to:

• Change Request (CR) Number: CR 13882
• Updated Medicare Claims Processing Manual, Chapter 11, Sections 30.3, 40.2 & 50
•  Processing Hospice Claims – Principal Diagnosis Code Reporting

These updates aim to streamline hospice claims processing and ensure accurate reporting. For more details, refer to Change Request (CR) Number: CR 13882, which includes updates to Medicare Claims Processing Manual, Chapter 11, Sections 30.3, 40.2, and 50. These changes are crucial for hospice providers to understand in order to avoid claim denials and ensure compliance with the latest CMS requirements.