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ALJ/MAC Decision Database



What are feeding tubes?


Tube feedings are used to provide nutrition and medication for individuals who are unable to swallow or who are having difficulty taking food and medication by mouth. There are four kinds of feeding tubes: naso-gastric tubes (NG tubes), which are inserted into the nose and down to the stomach;  gastric tubes (G-tubes), which are inserted through the skin of the abdomen and into the stomach;  jejunostomy tubes (J-tubes), which are surgically placed through the abdominal wall into the part of the small intestine called the jejunum; and percutaneous endoscopic gastrostomy tubes (PEG tubes), which are special G-tubes placed via an endoscopic procedure.


What is hospice care?


Hospice care is end of life care which focuses on the relief of symptoms (palliative care) and provides emotional and social support for the dying person and for those who care for the dying person (caregivers).


If I elect the Medicare hospice benefit, will I be prohibited from using a feeding tube?


The Medicare statute and regulations do not prohibit Medicare coverage of hospice care for beneficiaries with feeding tubes, nor do they prohibit the use of feeding tubes for people who are receiving Medicare hospice coverage.  The pertinent legal question for Medicare coverage of all hospice care is whether or not the beneficiary has a life expectancy of six months or less if the terminal illness runs its normal course.  Thus whether or not Medicare will cover hospice care for a terminally ill beneficiary with a feeding tube depends on the facts of each case and specifically how use of the feeding tube will contribute to the beneficiary’s individualized palliative care plan.


Where can I get more information?

For more information regarding the use of tube feeding for dying patients, go to the Hospice Foundation of America’s website at, the Family Caregiver Alliance website at, talk to the nurses at your local hospice, and most importantly, talk to your attending physician.


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