State Licensure and/or Federal Medicare Certification
Hospice Agency Application Materials
If your application is in accordance with Pennsylvania state licensure rules and regulations, the Division will issue you a license. Please keep in mind the length of time for the licensure process depends upon the accuracy of information provided.
Hospice Agency Application for Federal Medicare Certification
NOTE: State licensure as a home health agency is a requirement for federal certification.
After review and acceptance of the application materials and notification from CMS of the approval of the CMS-855A, the department will conduct a survey before recommending the agency for Medicare certification.
Mail completed forms to:
Please note change of address
Pennsylvania Department of Health
555 Walnut St.
7th Floor, Suite 701
Harrisburg, PA 17101