Form CMS-417 Hospice Request for Certification in the Medicare Program

What Is Form CMS-417?

This is a legal form that was released by the U.S. Department of Health and Human Services - Centers for Medicare and Medicaid Services and used country-wide. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is Form CMS-417?
A: Form CMS-417 is the Hospice Request for Certification in the Medicare Program.

Q: Who uses Form CMS-417?
A: Hospices use Form CMS-417 to request certification in the Medicare program.

Q: What is the purpose of Form CMS-417?
A: The purpose of Form CMS-417 is to collect necessary information for the certification of hospices in the Medicare program.

Q: What information is required on Form CMS-417?
A: Form CMS-417 requires information such as the hospice name, address, contact information, types of services provided, and certifications obtained.

Q: How should I submit Form CMS-417?
A: You can submit Form CMS-417 electronically or by mail, as per the instructions provided on the form.

Q: Is there a fee for submitting Form CMS-417?
A: There is no fee for submitting Form CMS-417.

Q: What happens after submitting Form CMS-417?
A: After submitting Form CMS-417, the Medicare Administrative Contractor (MAC) will review the information and make a determination regarding the certification of the hospice in the Medicare program.