Houston's hospice market is among the largest in the country, spread across Harris County's 1,777 square miles and extending into Montgomery, Fort Bend, Brazoria, and Galveston counties. Agencies here face a documentation challenge that's outsized even for a major metro: the patient population is extraordinarily diverse (Spanish-speaking families, Vietnamese-speaking patients in Bellaire and Sugar Land, large refugee and immigrant communities), and visits can span everything from dense inner-loop zip codes like 77030 (Medical Center) to rural stretches in unincorporated Harris County where connectivity is spotty.
Hospice nurses in Houston work under Novitas Solutions (Jurisdiction H), which administers Medicare hospice claims for Texas. Novitas's LCD criteria align closely with the national framework, and clinical documentation expectations reflect the same emphasis on PPS, functional decline, and diagnosis-specific criteria that CMS publishes nationally. The Houston region also sees high volumes of cancer hospice patients. Given MD Anderson's role as a major referral center, many patients transition to hospice after long oncology care journeys, and documentation often needs to bridge an oncology record with a hospice narrative.