Working in hospice as an OT, PT, or SLP
Hospice is end-of-life care for people with illnesses that cannot be cured. Federal Medicare rules list physical therapy, occupational therapy, and speech-language pathology as covered hospice services, provided for symptom control or to help the patient keep up daily activities and basic functional skills. A hospice must have these services available. Medicare.gov lists physical and occupational therapists and speech-language pathologists as possible members of the hospice care team. APTA and ASHA describe hospice and palliative roles for PTs, PTAs, and SLPs. The goal is comfort and function, not cure.
Quoted from official pages checked November 10, 2026. Confirm current requirements, fees, and dates on those sites. This page is not legal advice and does not guarantee eligibility, certification, or licensure.
What Medicare.gov says
Medicare.gov’s Hospice care page, checked November 10, 2026, states: “Hospice is end-of-life care for people with illnesses that can't be cured.” It says your plan of care might include any or all of a list of services, depending on your terminal illness and related conditions. The list includes “Occupational therapy services.”, “Physical therapy services.”, and “Speech-language pathology services.”
It says a hospice nurse and doctor are on call around the clock, and that the care team may also include “Physical and occupational therapists” and “Speech-language pathologists”. On eligibility, it says your hospice doctor and your regular doctor, if you have one, must certify you are terminally ill “(with a life expectancy of 6 months or less)”, and that you accept comfort care instead of care to cure the illness. These are coverage rules for patients, not employment rules. The page also covers patient costs, which are not copied here.
What the federal regulations say
42 CFR 418.202 (eCFR, up to date as of November 6, 2026) lists covered hospice services. Paragraph (h) reads: “Physical therapy, occupational therapy and speech-language pathology services in addition to the services described in § 409.33 (b) and (c) of this chapter provided for purposes of symptom control or to enable the patient to maintain activities of daily living and basic functional skills.”
42 CFR 418.72, a condition of participation for hospices, states: “Physical therapy services, occupational therapy services, and speech-language pathology services must be available, and when provided, offered in a manner consistent with accepted standards of practice.” These therapies are not among the hospice core services. 42 CFR 418.64 states that core services “include nursing services, medical social services, and counseling.”
Physical therapists and PTAs: APTA
APTA’s Hospice and Palliative Care page, checked November 10, 2026, states: “Physical therapy is increasingly acknowledged as a key component in hospice and palliative care.” It continues: “Care for patients with a serious illness or nearing end-of-life is evolving, and with that evolution comes an increased appreciation for the roles PTs and PTAs can play in these crucial times.”
It also states: “The core team, as defined by the Medicare Hospice Benefit, includes physicians, nurses, social workers, and bereavement counselors.” And: “The broader team includes providers of therapy services (eg, physical therapy, occupational therapy, and speech therapy), home health aides, chaplains, volunteers, dieticians, and pharmacists, as well as others involved in customizing appropriate care for each individual.” On the difference between the two: “Palliative care is not dependent on prognosis and can be provided along with curative treatment.”
Speech-language pathologists: ASHA
ASHA’s Palliative and End-of-Life Care Practice Portal page, checked November 10, 2026, states: “Speech-language pathologists (SLPs) can be part of interprofessional teams that incorporate either approach.” It continues: “SLPs work with individuals and their care partners to address swallowing, functional communication, and cognitive communication needs.” On hospice care: “The goal of SLP intervention for EOL care is not rehabilitative; it is to improve or maintain quality of life.” An older ASHA end-of-life address tried the same day returned ASHA’s page-not-found message, so nothing is quoted from it.
What BLS says
BLS’s handbook pages for occupational therapists, occupational therapy assistants and aides, physical therapists, physical therapist assistants and aides, and speech-language pathologists, checked November 10, 2026, have no separate hospice line in their lists of largest employers, so this page gives no BLS share for it. BLS’s hospital, nursing facility, and home health shares are on the related setting pages below.
Occupational therapy
The federal rules and Medicare.gov above name occupational therapy explicitly. AOTA setting pages were not read for this site, so no AOTA hospice wording is quoted.
What this page does not do
It gives no payment rates, patient costs, visit counts, or staffing levels. Hospices are often home-based, so home-visit rules in your state also apply; see working in home health.
Pay
This page copies no wages. BLS median pay by industry is on OT, OTA, PT, PTA, and SLP work settings, and national figures are on pay and outlook.