Hospice ADR Deadline Calculator

Medicare Administrative Contractors (MACs) require hospice agencies to respond to Additional Documentation Request (ADR) letters within 45 calendar days of the ADR letter date. This window includes weekends and holidays.

Documentation must be received by the MAC within this timeframe — meeting the postmark date alone is not sufficient. Failure to respond within 45 days may result in automatic claim denial and payment recoupment, forcing your agency into the formal appeals process.

Because transit time and internal review cycles consume a significant portion of this window, best-practice hospice compliance teams build internal milestones — assigning the case to billing within 5 days, completing clinical documentation by day 15, and finishing compliance review by day 30 — to ensure timely submission.