Hospice Eligibility by Diagnosis
Grounded in the MAC Local Coverage Determinations, each guide gives you the quick eligibility criteria, a composite documentation example, and a workflow for a defensible admission. Use the interactive Eligibility Checklist to walk any of these frameworks live.
Advanced cancer is the most common hospice diagnosis and one of the clearest LCD frameworks.
Learn moreHeart failure is one of the most commonly under-documented hospice-eligible diagnoses.
Learn moreCOPD is one of the hardest hospice-eligible diagnoses to document well because decline is slow and non-linear.
Learn moreDementia is one of the most common hospice diagnoses and also one of the most under-documented at admission.
Learn moreRenal failure eligibility depends primarily on whether the patient is pursuing dialysis or transplantation.
Learn moreEnd-stage liver disease eligibility centers on lab-based synthetic-function markers plus at least one major decompensation, in a patient who is not a transplant candidate or is declining.
Learn moreThe MAC neurological LCD is broad — it applies to advanced multiple sclerosis, Huntington’s disease, muscular dystrophies, and other neurodegenerative conditions not covered by more specific LCDs (ALS, Parkinson’s, dementia, stroke).
Learn morePost-stroke hospice eligibility applies to patients with severe residual deficits at 6+ weeks post-event plus decline.
Learn moreALS is one of the clearest hospice-eligible diagnoses.
Learn moreAdvanced Parkinson’s eligibility parallels the dementia LCD in structure but centers on the motor and swallowing complications specific to advanced PD (or PD-related dementia).
Learn moreContent grounded in authoritative sources
Educational content only. Not a substitute for your organization’s policies, your medical director’s clinical judgment, or current CMS guidance. See individual pages for author/reviewer bylines and last-reviewed dates.
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