Certification and Recertification of Terminal Illness and Face-to-Face Encounters
Sets how the Agency obtains written certification and recertification of terminal illness for each benefit period (42 CFR §418.22): who may certify, when, and what the certification must contain, including the physician’s own narrative; face-to-face encounters before the third benefit period and every later one; when telehealth may and may not be used for those encounters through December 31, 2027; and the Florida duty of the medical director to validate the prognosis.
About this policy
- Policy number
- FL-HSP-ELC-02
- Version
- 1.0
- Main rule
- 42 CFR §418.22
- Library
- Florida hospice · 60 policies
- Category
- Hospice care
- Sections
- 20
In short
- Every benefit period needs a signed physician certification before billing: 90 days, 90 days, then every 60 days.
- First period: the hospice physician and the attending physician (if any, and a doctor) both certify.
- The physician writes the narrative personally and signs right below the attestation. Never pre-write it.
- From the third period, a hospice physician or nurse practitioner must see the patient within 30 days before recertification.
- Do face-to-face visits in person while a hospice moratorium covers Florida, unless the Administrator approves telehealth in writing.
What's inside
20 sections. The full text comes with the One-time Policy Pack.
- Terms of Reference
- 1. Purpose
- 2. Scope
- 3. Definitions
- 4. Policy Statement (42 CFR §418.22; Rule 59A-38.008(2)(b)2., F.A.C.)
- 5. Who Certifies
- 6. Timing
- 7. Content of the Certification
- 8. Face-to-Face Encounters
- 8.1 Telehealth face-to-face encounters
- 9. Patients Who Are Not Medicare Beneficiaries
- 10. When a Patient Cannot Be Recertified
- 11. Recording Certifications
- 12. Responsibilities
- 13. Records and Compliance Monitoring
- 14. Staff Training
- 15. References
- 16. Related Policies and Forms
- 17. Approval
- 18. Revision History
An inspector may ask
- Show me the certification for this patient’s first benefit period. Who signed, and on what dates?
- Where is the physician’s narrative, and the attestation directly above the signature?
See Cura Core with your agency's name on it.
Choose your state and type of agency, buy your Policy Pack online and get your sign-in by email. Already a customer? Sign in to your portal.