CMS Regulations


The hyperlinks below provide direct access to regulatory information provided by CMS. Click the red underlined text to navigate to the corresponding page. The CMS guidance will open in another tab so you can keep your place in the Axxess Help Center.

Medicare Benefit Policy Manual

Chapter 9: Coverage of Hospice Services Under Hospital Insurance


Chapter 9 of CMS’ Medicare Benefit Policy Manual provides regulatory information related to hospice service coverage, including:

  • Certification and Election Requirements
  • Timing and Content of Certification
  • Election, Revocation, and Discharge Regulations
  • Benefit Coverage and Covered Services Information

This chapter is one of the most helpful resources when starting out.


Chapter 11: Processing Hospice Claims


Chapter 11 provides information on claims processing and submission, including procedures for hospice election and the following related transactions:

Hospice Election and Related Transactions

  • Notice of Election (NOE)
  • Notice of Termination/Revocation (NOTR)
  • Change of Provider/Transfer Notice
  • Cancellation of an Election
  • Change of Ownership Notice

State Operations Manual

Guidance to Surveyors


Appendix M of the CMS State Operations Manual provides guidance to hospice surveyors. All hospice surveyors are required to use the regulations outlined in Appendix M, when assessing hospice agencies’ compliance with Federal requirements. This information is helpful for hospice professionals to understand which items and areas of the organization must be inspected or reviewed during surveys, and ensure that all requirements are met and all organizational operations remain compliant with CMS requirements.

HIS Manual

Guidance Manual for Completion of the Hospice Item Set (HIS)


The HIS Manual provides comprehensive guidance for completing the Hospice Item Set and submitting HIS files to CMS through the Quality Improvement and Evaluation System (QIES) Assessment Submission and Processing (ASAP) system. The manual is broken down into sections, including:

  • Background and Overview
  • Item-Specific Instructions
  • Submission and Correction of HIS Records


Note: Throughout the Axxess Hospice system, embedded tool tips provide guidance directly from the HIS Manual to assist users as they complete each HIS item.

CMS Hospice Center

CMS Hospice Center


The Hospice Center has the most up-to-date releases from CMS, including the annual Hospice Wage Index and the Final Rule, which adds new compliance requirements each year.


Hospice professionals can subscribe to MLN Connects Provider eNews to receive a weekly newsletter with the latest information on:

  • CMS program and policy details
  • Updates and announcements
  • Press releases
  • Upcoming educational event registration and reminders
  • Claim, pricer, and code information
  • Updates on new and revised MLN Publications

CAHPS Hospice Survey

CAHPS Hospice Survey Website


CMS’ official website for the CAHPS Hospice Survey provides comprehensive information on CAHPS survey requirements for hospice agencies, compliance, and additional information including the following sections:


Axxess is a CMS-approved vendor for CAHPS Hospice Surveys. Click here for additional information on AxxessCAHPS for Hospice.


Hospice Quality Reporting Program (HQRP)


The HQRP website provides provides consumer and provider information regarding the HQRP (mandated by the Affordable Care Act of 2010) and analytic information on CMS’ public reporting of HIS and CAHPS Hospice Survey data.


Hospice professionals can subscribe to the PAC QRP listserv for the latest hospice quality reporting information including training, stakeholder engagement opportunities, and general updates on the following items:

  • Reporting Requirements
  • Quality Measures
  • Reporting Deadlines