Medicare Benefit Policy Manual (Pub. 100-02), Ch. 9 § 40.1.3.1
Attending Physician Services
40.1.3.1 - Attending Physician Services
(Rev. 246, Issued: 09-14-18, Effective: 12-17- 18, Implementation: 12-17-18)
The attending physician is a doctor of medicine or osteopathy, a nurse practitioner, or a
physician assistant and is identified by the individual, at the time he or she elects to
receive hospice care, as having the most significant role in the determination and delivery
of the individual’s medical care.
The election statement must include the patient’s choice of attending physician. The
information identifying the attending physician should be recorded on the election
statement in enough detail so that it is clear which physician, NP, or PA was designated
as the attending physician. This information should include, but is not limited to, the
attending physician’s full name, office address, NPI number, or any other detailed
information to clearly identify the attending physician. Hospices have the flexibility to
include this information on their election statement in whatever format works best for
them, provided the content requirements in 42 CFR 418.24(b) are met. The language on
the election form should include an acknowledgement by the patient (or representative)
that the designated attending physician was the patient’s (or representative’s) choice.
If a patient (or representative) wants to change his or her designated attending physician,
he or she must follow a procedure similar to that which currently exists for changing the
designated hospice. Specifically, the patient (or representative) must file a signed
statement with the hospice that identifies the new attending physician in enough detail so
that it is clear which physician, NP, or PA was designated as the new attending physician.
This information should include, but is not limited to, the attending physician’s full name,
office address, NPI number, or any other detailed information to clearly identify the
attending physician. The statement must include the date the change is to be effective,
the date that the statement is signed, and the patient’s (or representative’s) signature,
along with an acknowledgement that this change in the attending physician is the
patient’s (or representative’s) choice. The effective date of the change in attending
physician cannot be earlier than the date the statement is signed.