Hospice and Palliative Care EHR and Billing

Palliative and hospice care follow patients into homes, facilities and hospitals. XEHR keeps goals of care and billing consistent across all of them.

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Chart · Office visit

Lastname, Firstname M. Sample patient · DOB 01/01/1980 · Commercial

Eligible

BP128/82

HR72

BMI26.4

Temp98.6

Progress noteAI Scribe draft

Goals-of-care discussion with the family.

Z51.5 Encounter for palliative care

ReviewSign note

Diagnosis carried to the claimZ51.5

THE HARD PARTS

What makes hospice and palliative care billing hard

Advance care planning conversations

These conversations are billable by time, but only when documented.

Care in many locations

Home, facility and hospital visits are billed differently.

Coordination with hospice benefits

Physician services may be billed differently once a patient elects hospice.

WHERE THE WORK HAPPENS

How hospice and palliative care care is delivered and billed

Hospice and palliative physicians work in hospice programs, hospital palliative care teams, nursing facilities and patients’ homes. Palliative consultations are billed as visits on the professional claim; hospice care under Medicare is paid to the hospice agency per day, while the patient’s attending physician may bill their own services separately. Certification of terminal illness and face-to-face requirements govern eligibility.

What payers check on hospice and palliative care claims

Hospice eligibility under Medicare requires certification that life expectancy is six months or less if the illness runs its normal course.
A face-to-face encounter is required before recertification for the third benefit period and each one after.
An attending physician who is not employed by the hospice bills their services with the modifier that shows they are unrelated to the hospice payment.
Advance care planning is billed by time and must be voluntary.
The palliative care encounter code is reported with the underlying illness.

Common hospice and palliative care diagnoses ICD-10-CM

Z51.5	Encounter for palliative care
C34.90	Malignant neoplasm of unspecified part of unspecified bronchus or lung
G30.9	Alzheimer’s disease, unspecified
I50.9	Heart failure, unspecified
J44.9	Chronic obstructive pulmonary disease, unspecified
R62.7	Adult failure to thrive

Examples only. The provider chooses the code that matches the documented diagnosis, and XEHR checks it against the note and the payer's rules before the claim goes out.

A VISIT ON XEHR

A hospice and palliative care visit, start to payment

1
Understand goals

The visit documents the patient’s goals, symptoms and who makes decisions.
2
Manage symptoms

Pain and other symptoms are assessed and the plan is recorded.
3
Plan ahead

Advance care planning conversations are recorded with their time.
4
Bill the right way

Palliative visits go out on claims; hospice-related services follow the hospice benefit rules.

How XEHR helps

From the hospice and palliative care visit to the payment

Goals of care in one placeWishes and plans are documented and visible to the team.
Location chosen per visitClaims carry where care happened.
Coverage recordedBenefit status is recorded with the patient so claims go to the right payer.
AI that waits for youThe AI drafts notes and prepares claims; your providers sign and your billers approve.

Claim · CMS-1500

Sample claimLastname, Firstname M. · DOS 03/04/2026

Scrub passed

Scrubbed
Submitted
Accepted
Paid

Service	Dx	Units	Charge
Office visit	E11.9	1	145.00
A1c test	E11.9	1	28.00
Total			173.00

ERA postedPayment applied, no re-keying

Agentic AI for hospice and palliative care

AI medical billing for hospice and palliative care practices

XEHR is an agentic EHR: AI agents do the administrative work around every hospice and palliative care visit, and your team approves what matters. How agentic AI works

Before the claim leaves

The claim-check agent looks for

Hospice eligibility under Medicare requires certification that life expectancy is six months or less if the illness runs its normal course.
A face-to-face encounter is required before recertification for the third benefit period and each one after.
An attending physician who is not employed by the hospice bills their services with the modifier that shows they are unrelated to the hospice payment.
Advance care planning is billed by time and must be voluntary.

Around the visit

Agents run on their own

Coverage checked before each hospice and palliative care visit
The visit note drafted for the provider to sign
Insurance payments matched and posted
Open claims tracked, denials read and appeals drafted

People decide

Your team stays in charge

Providers sign every note
Billers approve every claim and appeal
Staff submit prior authorizations
Any check can be overridden, with a reason

BUYER'S GUIDE

Questions to ask before you choose a hospice and palliative care EHR

Ask every vendor, including us. The answers show whether a system was built for hospice and palliative care work or only adapted to it.

Ask us on a demo

Are hospice certification periods and face-to-face deadlines tracked?
Is advance care planning time recorded?
Can attending physician services be billed separately from the hospice payment?
Are goals of care documented clearly?
Can palliative consults be billed in every setting?

QUESTIONS

Hospice and Palliative Care practices ask us

Can XEHR document advance care planning?

Yes. Conversations and time are documented and carried onto the claim.

Does XEHR support home visits?

Yes. The visit location is chosen per visit.

Does XEHR support palliative care teams?

Yes. Goals, symptoms and advance care planning are documented and billed from one record.

Can XEHR track hospice certification dates?

Yes. Certification periods and face-to-face deadlines are tracked on the patient record.

Does XEHR support home-based palliative care?

Yes. Home visits carry the home place of service.

Can XEHR record symptom scores?

Yes. Scores are recorded at each visit.

How much does XEHR cost for a hospice and palliative care practice?

Pricing is published: $189 per provider per month for the Clinical plan, $449 per provider per month for the Practice Suite with billing, or 2.5% of collections for RCM as a Service. Month-to-month, with a BAA on every plan. See pricing.

How long does it take a hospice and palliative care practice to go live?

Small practices are usually live in 2 to 4 weeks, including setup, data migration and training. We agree the plan with you before you sign.

Related specialties

See all specialties

See XEHR set up for hospice and palliative care

A 30-minute walkthrough on a live test environment, with your specialty's templates and billing.

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