General Guidelines

The eligibility criteria contained within these pages are related to specific diagnoses that the Centers for Medicare and Medicaid Services (CMS) has provided. Although these guidelines are limited to a select list of diagnoses for hospice benefit coverage it is not to be considered an all-inclusive list. In fact, any disease process in the terminal stage is appropriate for hospice care. Hospice appropriate individuals may exhibit some or all of the following:

  • Frequent hospitalizations
  • Progressive weight loss
  • Deteriorating mental abilities
  • Recurrent infections
  • Overall decline in condition

Who should receive hospice care?

  • Individuals with an illness causing a limited life expectancy of 6 months or less, if the disease runs its normal course.
  • Individuals who have chosen palliative care that focuses on symptom management rather than curative treatment
  • Individuals who choose no extreme measures to sustain life

For determination of hospice care eligibility, please contact your local Compassus program for further clarification or to request an assessment.