For physicians, nurses and discharge planners
What is the KPS scale in hospice?
The Karnofsky Performance Status (KPS) rates function from 100, normal, to 0 in ten-point steps. It is one of the two functional scales the Medicare hospice LCD guidance names, with the Palliative Performance Scale: a KPS below 70% with dependence in at least two activities of daily living is the baseline for most diagnoses. Beta Hospice in San Bernardino scores it at the evaluation visit.
Medically reviewed by Oscar Chien, MD, Medical Director, October 26, 2026
On this page (4 sections)
What are the Karnofsky scores?
The Karnofsky Performance Status rates function from 100 (normal) to 0 (death) in ten-point steps. It predates the PPS and is still named in the LCD guidance alongside it.
| Score | Description |
|---|---|
| 100 | Normal; no complaints; no evidence of disease |
| 90 | Able to carry on normal activity; minor signs or symptoms of disease |
| 80 | Normal activity with effort; some signs or symptoms of disease |
| 70 | Cares for self; unable to carry on normal activity or to do active work |
| 60 | Requires occasional assistance but is able to care for most needs |
| 50 | Requires considerable assistance and frequent medical care |
| 40 | Disabled; requires special care and assistance |
| 30 | Severely disabled; hospital admission indicated although death not imminent |
| 20 | Very sick; hospital admission necessary; active supportive treatment necessary |
| 10 | Moribund; fatal processes progressing rapidly |
| 0 | Dead |
Karnofsky DA, Burchenal JH, 1949.
What KPS score qualifies for hospice?
The LCD guidance uses a KPS or PPS below 70% together with dependence in at least two activities of daily living as the baseline for most diagnoses. Some diagnosis sections set a lower score: the stroke and coma criteria look for a KPS or PPS of 40% or less, and the adult failure to thrive criteria use the same 40%. A score alone never decides eligibility: the physician's prognosis, the LCD indicators, the rate of change and the comorbidities do.
KPS and PPS are interchangeable in the guidance, and the thresholds are the same numbers. PPS was built for palliative populations, so most hospices chart PPS; see the PPS scale. Chart one scale consistently: the trend over months supports a prognosis more than any single score.
Related guides
All four eligibility scales, the PPS scale, the eligibility guidelines by diagnosis and how to refer.
Common questions
What KPS score qualifies for hospice?
A KPS below 70% with dependence in at least two activities of daily living is the LCD baseline for most diagnoses; the stroke and coma and adult failure to thrive criteria look for 40% or less. The score supports the physician's prognosis; it does not replace it.
Is KPS the same as PPS?
No, but the LCD guidance names both and the thresholds are the same numbers. PPS adds columns for intake and consciousness and was built for palliative patients, so most hospices chart PPS.
About this page
- Written by
- Beta Hospice care team
- Medically reviewed by
- Oscar Chien, MD, Medical Director
- Last reviewed
- October 26, 2026
- Next review
- April 26, 2027
How we write and review this site
Sources
- CMS Medicare Coverage Database: LCD L33393, Hospice: Determining terminal status (opens in a new tab)
- National Cancer Institute: Karnofsky Performance Status (NCI Dictionary) (opens in a new tab)
- Victoria Hospice Society: Palliative Performance Scale (PPSv2) (opens in a new tab)
These sources support the general information on this page. For one person鈥檚 care and coverage, talk with the hospice team.
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