Healthcare Professionals
Hospice Eligibility Guidelines
A clinical reference for physicians and other referring providers.
Medicare Hospice Eligibility Criteria
A patient is eligible for the Medicare Hospice Benefit when:
- ✓Two physicians certify a prognosis of six months or less if the illness runs its normal course (the patient's attending physician and the hospice medical director)
- ✓The patient has a terminal diagnosis, including cancer, heart failure, COPD, dementia, renal failure, liver disease, ALS, stroke, and others
- ✓The patient elects comfort-focused care and agrees to forgo curative treatment for the terminal diagnosis
Important clinical notes
The six-month prognosis is a clinical judgment, not a guarantee. Patients can remain on hospice beyond six months if they continue to decline. If a patient improves, they can be discharged from hospice and re-enrolled later.
Common clinical indicators for specific diagnoses are available on request. Contact our medical director if you have questions about a specific patient.
Questions about a specific patient?
Call our referral line, we'll help you assess eligibility at no obligation.
📞 (803) 744-3550