Q4 2024 Medical Review Denial Trends in Hospice Care

Palmetto GBA has also released the latest data for Q4 2024 on the most common hospice claim denial codes. These findings are essential for hospice providers working to maintain compliance and ensure proper reimbursement under Medicare.

Top Denial Codes for Hospice Claims:

• Election statement errors
• Plan of care not signed/timely
• Certification or recertification documentation missing
• Services billed not supported by medical necessity
• Face-to-face encounter documentation incomplete or invalid

Agency Recommendations:

• Standardize your admission packet and review process.
• Train staff on certification timing rules and documentation standards.
• Perform internal chart reviews before billing.
• Use EMR alerts or workflows to flag missing F2F or certifications.

Staying compliant not only speeds up reimbursement but also prevents potential recoupments. Access the full Palmetto GBA report here.