Hospice telehealth face-to-face encounters: the new restrictions are already live
The face-to-face encounter required before hospice recertification (42 CFR §418.22(a)(4)(ii)) may generally be conducted via telehealth under the CAA 2026's extension of that flexibility through December 31, 2027 (§6209(f)(1)(A)) — but the same law carved out hard exceptions (§6209(f)(1)(B)). For encounters on or after January 31, 2026, telehealth may not be used when the patient is located in an area subject to a hospice enrollment moratorium, when the hospice is under enhanced oversight, or when the encounter would be performed by a hospice physician or nurse practitioner who is not Medicare-enrolled (and is not an opt-out practitioner). In those situations, the encounter must be in person.
The second date: for telehealth F2F encounters on or after January 1, 2027, claims must include the modifier or code CMS specifies identifying the encounter as telehealth-conducted (§6209(f)(2)). The FY 2027 proposed rule (CMS-1851-P) includes the conforming regulation text.
Why this bites: the enhanced-oversight and moratorium conditions are not static facts about your agency — they're facts about geography and status that can change under you. A hospice that slips into enhanced oversight mid-year loses telehealth F2F eligibility for affected patients immediately, and a recertification supported by an impermissible telehealth encounter is a technical-eligibility defect in the claim itself.
What to do now
- Confirm today whether your agency or any service area is under enhanced oversight or an enrollment moratorium — and assign someone to re-check on a schedule.
- Verify Medicare enrollment status for every physician and NP who conducts F2F encounters.
- Have your billing team stage the 2027 modifier requirement now; retrofitting claim logic in December is how January denials happen.