CG-MED-101 Home Hospice

This policy addresses home hospice services provided in the home, including routine home hospice and continuous home care. Coverage is medically necessary when the individual is terminally ill (e.g., life expectancy of 6 months or less), requires services to manage the terminal illness and related conditions, and needs either routine home hospice care (less than 8 hours of predominantly nursing care in a 24‑hour day) or continuous home care meeting policy criteria; services are not medically necessary when these criteria are not met.

"Home hospice services are consideredmedically necessarywhenbothof the following criteria (A and B) below are met:"

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