Medicare Hospice Reimbursement


Changes to the Medicare Hospice Regulations have occurred over the past few years and continue. Is your hospice thriving? Has your hospice adapted to the new Election Statement and Addendum requirement? Do you know where your agency stands in regard to PEPPER targets?

Be among the elite group of hospice professionals that are current on all Hospice Medicare reimbursement related regulations. This workshop will lay a concrete foundation for hospice billers, as well as, any hospice staff that need to more effectively understand the Medicare regulations. This workshop will include Medicare field by field on Notice of Election and claim forms and sequential billing requirements.

The 2020/21 Claims Requirements will be detailed including a review of the new Routine & other levels of Hospice rates will be conducted. The workshop will detail the CMS Targeted Probe & Educate initiative while also reviewing the regulations for face-to-face encounters and pre-claim reviews that should be conducted prior to filing claims. The workshop will conclude with many analyzing the PEPPER information and how hospices can work toward improvement in their scores. If you are play any part in the responsibility of reimbursement in your hospice this workshop is a must.

  • List the basic eligibility requirements for initiating Hospice and Billing to Medicare.
  • Conduct overview of eligibility requirements for the Hospice Benefit.
  • Review Benefit Periods & Eligibility.
  • Review Notice of Election details.
  • Detail criteria for line item billing Hospice Notice of Election and Claims to Medicare.
  • Review the requirements of the new Election Statement Addendum.
  • Review line item requirements including 15-minute increments for claims.
  • Review Sequential billing requirements with examples.
  • Pre-Bill Audit Tool Review.
  • Detail Specific Medicare Regulatory Issues affecting Hospice Reimbursement.
  • Review Hospice Face-to-Face Requirements.
  • Audit Risks – CMS Targeted Probe & Educate.
  • Review effect of PEPPER Reports on Medicare Review.
  • List the Target areas for Hospice PEPPER and the use of the data.
  • Review criteria that lead to target scores higher than the National numbers.
  • Review steps agency should take for improvement in scores.



Melinda Gaboury, COS-C

Healthcare Provider Solutions, Inc.

Melinda A. Gaboury, with more than 29 years in home care, has over 19 years of executive speaking and educating experience, including extensive day to day interaction with home care and hospice professionals. She routinely conducts Home Care and Hospice Reimbursement Workshops and speaks at state association meetings throughout the country. Melinda has profound experience in Medicare PPS training, billing, collections, case-mix calculations, chart reviews and due diligence. UPIC, RA, ADR & TPE appeals with all Medicare MACs have become the forefront of Melinda’s current impact on the industry. She is currently serving on the NAHC/HHFMA Advisory Board and is Treasurer of the Home Care Association of Florida Board of Directors. Melinda is also the author of the Home Health Guide to OASIS-D1: A Reference for Field Staff.


Cancellations are subject to 20% handling fee. There will be NO REFUNDS issued for cancellations received within 10 business days prior to program. Cancellations must be in writing. Refunds will not be made for no-shows. However, substitutions will be allowed. Should CAHSAH® cancel the program, a full registration fee refund will be issued.


Provider approved by the California Board of Registered Nursing (Provider #CEP17394) for five and one half (5.5) contact hours of continuing education. You must be present for the entire workshop to earn Continuing Education Units. No partial credits can be given. Certificates are distributed at the close of the program.