Benefit Period & Recertification Calculator
Enter the patient's current benefit period and its start date to see when the period ends, when the next one begins, and the windows for recertification and the face-to-face encounter.
Patient details
Defaults to today. Change it to plan ahead.
Which period the patient is in now (1, 2, 3, …).
Complete the patient details in the form on the left to see face-to-face and recertification dates.
How recertification works
In hospice, a patient's eligibility must be recertified every 60 or 90 calendar days, depending on how long they have been on service. Medicare structures the hospice benefit into benefit periods:
- Initial period: two periods of 90 days each.
- Subsequent periods: an unlimited number of 60-day periods.
At the start of each new benefit period the patient must be recertified. If the recertification is not in effect before the next period begins, the agency may not bill Medicare for care provided from the start of the new period until the recertification is completed.
Recertification timing
A recertification may be completed no more than 15 days before the new benefit period begins, and should be in place before the period starts to keep coverage continuous. If a written recertification cannot be completed before the new period, Medicare requires an oral or written recertification no later than 2 calendar days after the period starts (by the end of the third day).
Face-to-face encounters
Beginning with the third benefit period (the first 60-day period) and every period after, a face-to-face encounter is required to recertify the patient. It may be conducted up to 30 days before the new period begins, and may also occur on the first day of the new period and still be considered timely. The first two 90-day periods do not require a face-to-face encounter.
Counting the days — an example
Suppose a patient is admitted to hospice on April 1 (Day 1 of the first 90-day period):
- Day 90 — the last day of the period — is June 29.
- The next benefit period begins on June 30 (Day 91).
- The recertification can be completed any time from June 15 through June 29.
- No face-to-face is required, because the next period is only the second 90-day period.
Please note:The recertification dates calculated by this tool relate to the next benefit period, not the current benefit period. This tool is provided for educational purposes to help with planning and does not replace official Medicare guidance or your agency's compliance processes. Always verify dates against current CMS requirements.