CMS Pub. 100-04, ch. 11, § 20.1.3

If the beneficiary is transferred to another hospice (discharge status codes 50 or 51) the claim does not

terminate the beneficiary’s current hospice benefit period. The admitting hospice submits a transfer

notice after the transfer has occurred and the beneficiary’s hospice benefit is not affected. The 8XC

does not get submitted until after the other provider has finalized their billing.

NOTE: Transfers are not allowed from the same provider. Hospices must not submit an 8XC if the

CMS Certification Number (CCN) is the same. In this scenario the beneficiary is not transferred to

another hospice, they are transferred to another location of the same hospice.

A beneficiary can change hospices only once per benefit period (90-day or 60-day). When the

beneficiary transfers to a different hospice, he/she continues in the same benefit period. To transfer

hospice programs, the individual or representative must file, with the hospice from which care has

been received and with the newly designated hospice, a statement that includes the following

information:

(1) The name of the hospice from which the individual has received care and the name of

the hospice from which he or she plans to receive care.

(2) The date the change is to be effective.

Given that hospices bill for the date of discharge or transfer, for claims purposes, the “From” date for

the receiving hospice must be the same as the “Through” date for the transferring hospice, otherwise

this would constitute a gap in care and a gap in billing and would not be considered a transfer. For

example, if a beneficiary designates that a transfer is to be effective on January 10th, the transferring

hospice’s “Through” date must be January 10th and the receiving hospice’s “From” date must be

January 10th in order to be a continuous hospice election without a gap in care or billing. That is, the

transferring hospice is responsible for the beneficiary up until, and including the transfer date.

If the beneficiary is transferring from outside the service area and the transferring hospice cannot

arrange care until the beneficiary reaches the new hospice, the hospice may discharge the

beneficiary. This way, if the beneficiary requires medical treatment while in the process of

transferring, he/she can access it under his/her traditional Medicare coverage. This would terminate

the beneficiary’s current benefit period and require the beneficiary to re-elect hospice coverage at the

new hospice and begin a new benefit period.

The hospice transfer will be rejected if the transfer does not occur immediately. If the receiving

hospice’s claim “from date” is not the same as the “through date” with "patient status” indicating a

transfer (codes 50 or 51), the transfer will be rejected. The edit will not apply to a subsequent claim,

if a transfer is posted and the hospice’s claim “from date” is the same as the “transfer date”.

Type of Bill

Enter the appropriate 3-digit numeric type of bill code, according to the following code structure:

81C - Hospice (Non-hospital Based) Change of provider

82C - Hospice (Hospital Based) Change of provider

Statement Covers Period (From-Through)

The “From” date would be the date the change is effective. No through date is required.

Patient’s Name

The patient’s name is shown with the surname first, first name, and middle initial, if any.

Patient’s Address

The patient’s full mailing address including street name and number, post office box number or RFD,

city, State, and ZIP code.

Patient’s Birth Date

Show the month, day, and year of birth numerically as MM-DD-YYYY.

Patient’s Sex

Show an “M” for male or an “F” for female. This item is used in conjunction with

diagnoses and surgical procedures to identify inconsistencies.

Admission Date

The hospice enters the admission date, which must be the start date of the benefit period in

all cases except when a transfer occurs. In transfer situations, the receiving hospice should

use their own admission date. When a new hospice admission occurs after a hospice

revocation or discharge that resulted in termination of the hospice benefit, the new admission

date cannot be the same as the revocation or discharge date of the previous benefit period.

Show the month, day, and year numerically as MM-DD-YY.

Condition Codes

Condition codes are not required on an original transfer notice. If the hospice is

correcting a date of transfer using occurrence code 56, the hospice reports condition code

D0. If the two codes are not reported together, the transfer notice will be returned to the

hospice.

Occurrence Codes and Dates

An occurrence code 27 is not required on a transfer notice, unless the date of transfer is

also the first day of the next benefit period.

Hospices may submit a transfer notice that corrects a date of transfer previously

submitted in error. In this case, the hospice reports the correct effective date of the

transfer in the From Date field and reports the original, incorrect effective date using

occurrence code 56. Medicare systems use the original, incorrect date to find the benefit

period to be corrected, then replaces that date of transfer with the corrected information.

Release of Information

Valid values are:

I- Informed consent to release medical information for condition or diagnoses

regulated by Federal Statutes

Y -Yes, provider has a signed statement permitting release of information.

Provider Number

The hospice enters their NPI.

Insured’s Name

Send all NOEs with Medicare as the primary payer. Enter the beneficiary’s name on line

A. Show the name exactly as it appears on the beneficiary’s HI card.

Insured’s Unique Identifier

On the same lettered line (A, B, or C) that corresponds to the line on which Medicare

payer information is shown enter the patient’s unique identifier by the health plan for the

insured. For example, if Medicare is the primary payer, enter the MBI. To ensure

accuracy and prevent a delay in the timely receipt or posting the hospice notice of

election, hospices should validate this information using the Health Insurance Portability

and Accountability Act (HIPAA) Eligibility Transaction System (HETS). Only in the

event that the HETS data is not available should the hospice show the number as it

appears on the patient’s HI Card, Social Security Award Certificate, Utilization Notice,

EOMB, Temporary Eligibility Notice, etc., or as reported by the SSO.

Principal Diagnosis Code

CMS accepts only HIPAA approved ICD-9-CM or ICD-10-CM/ICD-10-PCS codes,

depending on the date of service. The official ICD-9-CM codes, which were updated

annually through October 1, 2013, are posted at

http://www.cms.gov/Medicare/Coding/ICD9ProviderDiagnosticCodes/codes.html

The official annual updates to ICD-10-CM and ICD-10-PCS codes are posted at

http://www.cms.gov/Medicare/Coding/ICD10/index.html

Use full diagnosis codes including all applicable digits, up to five digits for ICD-9-CM

and up to seven digits for ICD-10-CM.

Attending Physician I.D.

The hospice enters the name and provider identifier of the attending physician designated

by the patient at the time of election as having the most significant role in the

determination and delivery of the patient’s medical care. The patient’s designated

attending physician could be an independent physician, hospice physician, a nurse

practitioner, or physician assistant. If there is no attending physician listed, then the

hospice shall report the hospice certifying/recertifying physician.

Other Physician I.D.

The hospice enters the name and provider identifier of the hospice physician responsible for

certifying/recertifying that the patient is terminally ill, with a life expectancy of 6 months or less if the

disease runs its normal course. For electronic claims, this information is reported in Loop ID 2310F –

Referring Provider Name.

NOTE: Both the attending physician and other physician fields should be completed unless the

patient’s designated attending physician is the same as the physician certifying/recertifying the

terminal illness. When the attending physician is also the physician certifying/recertifying the

terminal illness, only the attending physician field is required to be populated, the other physician

field would not need to be populated.

Provider Representative Signature and Date

A hospice representative must make sure the required physician’s certification, and a signed hospice

election statement are in the records before signing the Form CMS-1450. A stamped signature is

acceptable.