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Welcome to the Legacy Hospice Physicians Portal

Legacy Hospice provides this portal as a resource to physicians in evaluating potential hospice patients.Medicare regulations are changing rapidly, and we realize as hospice providers the difficulty in maintaining compliance and staying up to date with the ever changing rules governing hospice care. Our goal is to provide you with one place where you can access everything you need in appropriately evaluating and determining hospice eligibility.

Helpful Information and Resources Description
Eligibility Criteria Visit Page |
Link to the Eligibility Handout, Palmetto Guidelines, and CGS Guidelines.
MAC Jurisdiction

View Document
Home Health/Hospice Medicare Administrative Contractor Jusrisdictions (HH&H MACs)
Quick Referral Form View Document
This link will open the Legacy Quick Referral Form in a new window.
NHPCO

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The National Hospice and Palliative Care Organization (NHPCO) is the largest nonprofit membership organization representing hospice and palliative care programs and professionals in the United States. The organization is committed to improving end of life care and expanding access to hospice care with the goal of profoundly enhancing quality of life for people dying in America and their loved ones.
Initial CTI View Document
Link to our Initial Certificate of Terminal Illness Form. A sample CTI is included.
Physician's Recertification of Terminal Illenss View Document
Karnofsky Score View Document
Used for all patients.
PPS Scale View Document
This is used interchangeably with the Karnofsky Score
FAST View Document
Required for Dementia patients.

Legacy Hospice will never bill a patient.

If a patient does not have medicare, medicaid, or private insurance, Legacy Hospice will take responsibility for that patients' needs related to the terminal illness for which they are admitted.