42 CFR § 418.25

§ 418.25 Admission to hospice care.

This regulation governs admission criteria for hospice care, requiring that patients be admitted only on the recommendation of the hospice medical director or a physician member of the interdisciplinary group, in consultation with the patient's attending physician. The certifying physician must consider the patient's terminal diagnosis, other health conditions, and current clinically relevant information before certifying terminal illness. This is a hospice-specific rule and does not govern any behavioral health, IDD, ABA, or foster care level of care.

§ 418.25 Admission to hospice care.

(a) The hospice admits a patient only on the recommendation of the medical director (or the physician designee, as defined in § 418.3) or the physician member of the hospice interdisciplinary group, in consultation with, or with input from, the patient's attending physician (if any).

(b) In reaching a decision to certify that the patient is terminally ill, the hospice medical director (or the physician designee, as defined in § 418.3) or the physician member of the hospice interdisciplinary group, must consider at least the following information:

(1) Diagnosis of the terminal condition of the patient.

(2) Other health conditions, whether related or unrelated to the terminal condition.

(3) Current clinically relevant information supporting all diagnoses.

[70 FR 70547, Nov. 22, 2005, as amended at 89 FR 64272, Aug. 6, 2024; 90 FR 37431, Aug. 5, 2025]