What is GIP? General Inpatient hospice level of care

General Inpatient (GIP) is one of the four Medicare hospice levels of care. It is a short-term, symptom-crisis level appropriate when a patient’s symptoms cannot be safely managed in another setting.

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

GIP, in one sentence

GIP is inpatient hospice care for a symptom-management crisis that cannot be managed at home or in a lower level of care. It is billed at the highest per-diem rate under the Medicare Hospice Benefit and is one of the most audited utilization patterns.

When GIP is appropriate

Common GIP indications: uncontrolled pain requiring frequent titration, uncontrolled symptoms (dyspnea, agitation, secretions) requiring nursing intervention beyond what routine home care can support, complex wound care requiring inpatient resources, and symptom-management for a patient who cannot be safely returned home.

When GIP is NOT appropriate

GIP is not a substitute for placement, respite care, or family caregiver relief. Extended GIP stays without an ongoing symptom-management crisis are the most common reason a hospice enters the OIG spotlight.

Documentation requirements

Every day of GIP requires documented clinical justification tied to the symptom crisis, active medical intervention, and a written plan to move the patient back down to routine home care as soon as clinically feasible.

Frequently asked questions

Where can GIP be provided?

In a hospice inpatient unit, a hospital, or a Medicare-certified skilled nursing facility that has a contract with the hospice.

How long can GIP last?

As long as the symptom-management crisis persists. GIP stays that persist without documented ongoing crisis are audit-risk.

What triggers OIG scrutiny of GIP?

High GIP utilization rates, long GIP stays without weaning to a lower level of care, and GIP admissions that begin at hospice admission.

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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