CMS is making changes to Chapter 9 of the Medicare Benefit Policy Manual to reflect updates in the 2026 hospice payment final rule. The effective date of the manual update is Jan. 7, 2026. Changes included in the hospice rule went into effect Oct. 1, 2025.
The update to the manual includes guidance on attestation requirements. The new language at 20.1 — Timing and Content of Certification notes the attestation “may” be a separate and distinct section of, or addendum to, the recertification form.
Also added: The attestation requirement may also be fulfilled by not only a clearly titled section of or an addendum to the recertification form, but also by a signed and dated clinical note within the medical record that documents clear indication that the face-to-face encounter occurred and includes the date of the visit, the signature of the practitioner who conducted the face-to-face encounter, and the date of the signature.
There’s also new specificity added for when another provider is performing the encounter: Where a nurse practitioner or noncertifying hospice physician performed the encounter, and the attestation is a separate and distinct section of, or an addendum to, the recertification, the attestation must state that the clinical findings of that visit were provided to the certifying physician, for use in determining whether the patient continues to have a life expectancy of 6 months or less, should the illness run its normal course.
At 20.2.2 — Hospice Revocation and 20.2.3 — Hospice Discharge, CMS adds, “ There is no waiting period for the hospice beneficiary to reelect the hospice benefit after revocation, and a subsequent election period can begin immediately after reelection if the individual continues to meet eligibility requirements.”