What is hospice recertification?

Every hospice benefit period after the first is a recertification. Recertification is the physician certification that the beneficiary continues to have a life expectancy of six months or less if the terminal illness runs its normal course.

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

Recertification, in one sentence

Recertification is the physician’s written certification, obtained at the beginning of each benefit period after the first, that the beneficiary remains hospice-eligible.

Timing

Recertification must be obtained no more than 15 calendar days before the start of the new benefit period. Some MACs allow a verbal certification obtained within 2 calendar days after the start of the period, followed by a written certification, but the safest workflow is written certification before the period begins.

Who signs

Recertification is signed by the hospice medical director (or physician member of the hospice IDG) and, for the initial certification only, also by the attending physician (if any). Subsequent recertifications require only the hospice physician’s signature.

Link to F2F

For recertification into the third benefit period and every subsequent benefit period, the F2F encounter (see our separate article) is required in the 30 days before the start of the new period. The F2F clinician’s narrative supports the certification.

Frequently asked questions

How many benefit periods can a beneficiary have?

Two 90-day periods followed by an unlimited number of 60-day periods, as long as the beneficiary continues to be certified as terminally ill.

What if the beneficiary is discharged and later re-elects hospice?

On re-election, they resume with the next unused benefit period. Days used previously are not reset.

What documentation supports recertification?

A written certification signed by the hospice medical director, a decline-narrative describing why the patient continues to meet a 6-month prognosis, and (for BP3+) the F2F clinician’s narrative.

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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