According to CMS, the timing and content for certification are for the first 90 days of hospice coverage. The hospice must obtain, no earlier than _____ days prior to care and no later than _____ calendar days after hospice is initiated, oral or written certification of the terminal illness by the medical director of the hospice or the physician member of the hospice organization.

• A. -30, 10
• B. -15, 2
• C. -10, 10
• D. -60, 15

Answer: (B)

The key idea is the timing window CMS sets for the initial certification of terminal illness in Medicare hospice during the first 90 days of coverage. This certification, whether oral or written and provided by the hospice medical director or a physician member, must be obtained no more than 15 days before hospice care begins and no later than 2 calendar days after hospice is initiated. This tight window ensures the patient is recognized as terminally ill from the start of care and that the qualifying documentation is current.

So the correct timing is 15 days prior to care and 2 days after initiation. Options that allow a longer pre-admission period or a longer post-admission period don’t fit CMS rules, while the chosen window precisely matches the requirement.