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MA94 Remark Code: Hospice Attending Statement Missing

MA94 means the claim did not include the statement 'Attending physician not hospice employee,' which certifies that the rendering physician is not employed by the hospice. Without it, the payer cannot pay the physician separately for the hospice patient's care.

Quick facts

Code
MA94 (RARC MA94)
Status
Active In use since January 1, 1997; last modified August 1, 2005.
Code set
Remittance Advice Remark Codes (RARC)
Group codes
  • CO (Contractual Obligation): The service was not paid because the required certification was missing. The physician corrects and resubmits; the patient is not billed.
Official description
Did not enter the statement 'Attending physician not hospice employee' on the claim form to certify that the rendering physician is not an employee of the hospice.
X12 Remittance Advice Remark Codes, retrieved September 25, 2026
Last verified
against the official X12 list.

What MA94 means

When a Medicare patient elects hospice, the hospice generally receives payment for care related to the terminal illness. An attending physician who is not employed by the hospice can still bill Medicare Part B for professional services. To do so, the claim must certify that independence. MA94 says the required statement, ‘Attending physician not hospice employee’, was not on the claim.

The official wording ties the remark to that certification specifically.

Common causes

  • The physician billed the hospice patient’s visit like any other visit, without the certification.
  • The statement was abbreviated or worded differently than the contractor requires.
  • The claim note was dropped by the billing system or clearinghouse.
  • The practice did not realize the patient was in a hospice benefit period.

How to fix it

  1. Confirm the patient’s hospice election and that your physician is the designated attending physician, not a hospice employee.
  2. Add the statement to the claim in the field and with the wording your contractor requires.
  3. Check modifiers, including GV for attending physician services related to the terminal condition, per Medicare guidance.
  4. Resubmit the claim as instructed by your contractor.

How to prevent it

  • Flag hospice patients in your system when eligibility shows a hospice election.
  • Build a rule to add the certification statement automatically when GV is billed.
  • Verify eligibility at each visit; see eligibility and COB denials.

Codes that may appear with MA94

  • CO-16 (Claim/service lacks information or has submission/billing error(s).): The claim lacks required information, here the attending physician certification statement.
  • CO-97 (The benefit for this service is included in the payment/allowance for another service/procedure that has already been adjudicated.): Without the certification, the service may be treated as included in the hospice's payment.
  • MA69 (Missing/incomplete/invalid remarks.): Missing or invalid claim remarks, the field where statements like this are usually entered.
  • MA76 (Missing/incomplete/invalid provider identifier for home health agency or hospice when physician is performing care plan oversight services.): A missing hospice or home health identifier on care plan oversight claims.

MA94 FAQ

Why does Medicare need this statement?

Services by hospice-employed physicians are generally billed by the hospice. The statement confirms the attending physician is independent and can bill Part B for related services.

Where is the statement entered?

Follow your Medicare contractor's current instructions for where the statement goes on paper and electronic claims. Medicare also identifies an independent attending physician's services related to the terminal condition with the GV modifier.

Does MA94 apply to services unrelated to the terminal illness?

Services unrelated to the terminal condition are billed differently (Medicare uses the GW modifier). MA94 concerns the attending physician certification.