NC · guidance
N.C. Medicaid Clinical Coverage Policy No. 3D § 5.2.2.1
First and Second Benefit Periods
The first (1st) benefit period and second benefit period (2nd) are both 90
calendar days. This begins the initial admission to Hospice service based
on the original election date for the beneficiary.
Beginning with the first (1st) benefit period, hospice providers must obtain
written certification of terminal illness for each benefit period throughout
the duration of hospice care to be maintained in the provider file
according to 42 CFR §418.22.
At the first (1st) benefit period the hospice provider (s) shall create a prior
approval request and upload the Election Statement which notifies NC
Medicaid of the beneficiary election of hospice service. The PA request
and election statement must be uploaded into NCTracks portal within six
calendar days of the effective date of the beneficiary election of hospice
service, according to 42 CFR 418.24.
The second (2nd) benefit period requires the entry of a PA request in to
NCTracks, however, the election statement is not required at this benefit
period
Provenance
- Source
- medicaid.ncdhhs.gov
- Retrieved
- 2026-10-01
- Edition
- ccp-3d-2024-03-15
- Content hash
51fb35fe42bc424d2094274c956cec40a59090a33948436496b5ed0dfb6cef2c
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