What is the hospice attending physician?

The attending physician is the doctor the hospice beneficiary chooses on their election statement as the primary medical clinician for the terminal illness. Under Medicare, the attending physician can be the community doctor the patient already sees; they are not required to be an employee of the hospice.

By Goodwin Hospice Academy Editorial Team· Published February 16, 2026·Last reviewed February 16, 2026· 5 min read

Attending physician, in one sentence

The attending physician is the beneficiary’s designated primary physician for the terminal illness, named on the hospice election statement.

Attending vs medical director

The attending physician is chosen by the beneficiary and may be a community-based physician outside the hospice. The hospice medical director is employed or contracted by the hospice and provides medical oversight of the plan of care and signs certifications/recertifications.

Billing implications

The attending physician can bill Medicare Part B for professional services related to the terminal illness (physician visits, care coordination). If the attending is also the hospice medical director, care must be taken not to double-bill.

Changing the attending

The beneficiary can change their attending physician at any time. The hospice must document the change and communicate with both the previous and the new attending.

Frequently asked questions

Can the attending physician be a nurse practitioner?

Yes. Since 2019, a nurse practitioner may serve as the attending clinician of choice on the hospice election statement. A physician’s signature is still required for the initial certification and recertifications.

Does the hospice pay the attending physician?

For hospice-related professional services, the attending physician typically bills Medicare Part B directly. Hospice pays only if the attending is contracted or employed by the hospice for hospice-related services.

What if the patient does not have an attending?

The hospice medical director serves as the physician of record.

Sources & further reading

Educational content only. Not a substitute for your organization’s policies, your medical director’s clinical judgment, or current CMS guidance.

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