For physicians, nurses and discharge planners
What is the PPS scale in hospice?
The Palliative Performance Scale (PPS) rates function from 100% to 0% in ten-point steps across five columns: ambulation, activity and disease, self-care, intake and consciousness. The Medicare hospice LCD guidance uses a PPS below 70% with dependence in at least two activities of daily living as the baseline for most diagnoses. Beta Hospice in San Bernardino charts it over time, because the trend supports the prognosis.
Medically reviewed by Oscar Chien, MD, Medical Director, October 26, 2026
On this page (4 sections)
What are the PPS levels?
The Palliative Performance Scale rates function in ten-point steps from 100% (normal) to 0% (death), reading five columns left to right: ambulation, activity and evidence of disease, self-care, intake and level of consciousness. The level is the first row where the patient's ambulation fits, adjusted by the later columns. Described here in our words; the instrument itself is published by Victoria Hospice.
| Level | Ambulation | Activity and disease | Self-care | Intake | Consciousness |
|---|---|---|---|---|---|
| 100% | Full | Normal activity and work; no evidence of disease | Full | Normal | Full |
| 90% | Full | Normal activity and work; some evidence of disease | Full | Normal | Full |
| 80% | Full | Normal activity with effort; some evidence of disease | Full | Normal or reduced | Full |
| 70% | Reduced | Unable to do normal work; significant disease | Full | Normal or reduced | Full |
| 60% | Reduced | Unable to do hobby or housework; significant disease | Occasional assistance needed | Normal or reduced | Full or confusion |
| 50% | Mainly sits or lies | Unable to do any work; extensive disease | Considerable assistance needed | Normal or reduced | Full or confusion |
| 40% | Mainly in bed | Unable to do most activity; extensive disease | Mainly assistance | Normal or reduced | Full, drowsy or confused |
| 30% | Totally bed bound | Unable to do any activity; extensive disease | Total care | Normal or reduced | Full, drowsy or confused |
| 20% | Totally bed bound | Unable to do any activity; extensive disease | Total care | Minimal, sips | Full, drowsy or confused |
| 10% | Totally bed bound | Unable to do any activity; extensive disease | Total care | Mouth care only | Drowsy or coma |
| 0% | Death |
Palliative Performance Scale (PPSv2), Victoria Hospice Society. The levels above paraphrase the instrument; use the published scale for scoring.
What PPS score qualifies for hospice?
The LCD guidance uses a PPS or KPS 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%. The dementia criteria rely on FAST rather than PPS. A falling PPS over months is itself a decline indicator.
A score describes where a patient is today. Eligibility rests on the physician's judgment of prognosis, supported by the LCD indicators, the rate of change and the comorbidities.
Related guides
All four eligibility scales, the KPS scale, the eligibility guidelines by diagnosis and how to refer.
Common questions
What PPS score qualifies for hospice?
A PPS below 70% with dependence in at least two activities of daily living is the LCD baseline for most diagnoses; some diagnosis sections set a lower score, and the score alone never decides eligibility.
How is the PPS level read?
Find the first row where the patient's ambulation fits, then adjust by the later columns: activity and disease, self-care, intake and consciousness. Use the published PPSv2 for scoring.
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)
- Victoria Hospice Society: Palliative Performance Scale (PPSv2) (opens in a new tab)
- National Cancer Institute: Karnofsky Performance Status (NCI Dictionary) (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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