A hospice chaplain is the spiritual care counselor on a hospice's team — the 'pastoral or other counselor' seat Medicare's hospice conditions of participation require on every interdisciplinary group (IDG).
The chaplain assesses each patient's and family's spiritual needs, counsels in line with their beliefs and desires, and makes reasonable efforts to arrange the local clergy visits families ask for.
Federal hospice regulation sets no degree or certification standard for the seat; each hospice decides the qualifications.
Clergy (SOC 21-2011), the closest available BLS pay group, earned a median of $60,810 a year in May 2025.
What is a hospice chaplain?
A hospice chaplain is the team member who addresses the patient's and family's spiritual needs at the end of life.
Medicare's hospice Conditions of Participation name the seat the "pastoral or other counselor."
Every Medicare hospice's interdisciplinary group (IDG) must include a pastoral or other counselor alongside a doctor of medicine or osteopathy, a registered nurse, and a social worker, marriage and family therapist or mental health counselor (42 CFR 418.56).
An RN in the group is designated to coordinate the patient's care.
Among the IDG's seats, the chaplain's is the one centered on spiritual work.
Titles for the seat include hospice chaplain, hospice spiritual care counselor and spiritual care coordinator; this guide uses hospice chaplain.
Federal hospice regulations spell out education standards for hospice social workers but set no degree or certification standard for the pastoral or other counselor — so board certification is an employer's choice rather than a government requirement.
The credential chaplains pursue through the Association of Professional Chaplains' Board of Chaplaincy Certification Inc. (BCCI) is Board Certified Chaplain (BCC).
BCC applicants need a bachelor's degree, a qualifying master's degree, 72 graduate semester hours in total, and four units of Clinical Pastoral Education.
They also need an endorsement from their faith group and at least 2,000 hours of chaplain work or volunteer experience after that clinical education.
BCCI also offers an Associate Certified Chaplain (ACC) credential with lighter requirements: 48 graduate semester hours and two CPE units.
Whether a hospice asks for board certification — and which credential it accepts — is up to that employer.
Confirm requirements with BCCI and with each employer
What they do
The core of the job is spiritual counseling, and CMS's hospice Conditions of Participation spell out what it must include (42 CFR 418.64).
- Assessing the spiritual needs of both the patient and the family.
- Counseling in a manner consistent with the patient's and family's beliefs and desires, and in accordance with their acceptance of the service.
- Making reasonable efforts to facilitate visits by local clergy or pastoral counselors.
- Advising the family that spiritual counseling is available.
Spiritual care plugs into the hospice's comprehensive assessment.
That assessment must cover physical, psychosocial, emotional and spiritual needs, include an initial bereavement assessment of the family, and be updated at least every 15 days.
Counseling is one of the hospice core services, and the rule expects hospices to provide core services — nursing, medical social services and counseling — directly through their own employees.
Contractors step in only to supplement employees in extraordinary or non-routine circumstances.
Hospice reaches patients in more than one setting.
Medicare hospice pays for four levels of care: routine home care, continuous home care, inpatient respite care and general inpatient care (42 CFR 418.302).
When a hospice serves nursing home residents, it does so under a written hospice-facility agreement signed before services begin (42 CFR 418.112).
A chaplain's caseload can span those settings.
The work does not stop at the patient's death.
Hospices must make bereavement services available to the family for up to 1 year after the death.
Who hires chaplains
The anchor employer is the Medicare-certified hospice.
Because every Medicare hospice must put a pastoral or other counselor on its interdisciplinary group, the seat is a required part of how a hospice staffs care, not an optional extra.
The employment model is set by the rule as well.
Hospices must routinely provide substantially all core services directly by hospice employees, so chaplaincy in hospice is an employee seat in the routine case, with contracted chaplains used only to supplement in extraordinary or non-routine circumstances.
The seat travels with the patient.
A hospice chaplain may spend part of a week visiting patients in their own homes, seeing residents of a nursing home the hospice serves under a facility agreement, and rounding in an inpatient hospice unit.
Hospices differ in size, service area and care settings, but the federal IDG requirement applies to all of them that participate in Medicare.
The role's range across home visits, facility partnerships and inpatient units follows from where hospice itself delivers care.
If your hospice is ready to hire for this role (employers), list the opening on the hiring hub.
If you are the candidate, browse hospice chaplain jobs.
Serving patients of all faiths and none
Hospice patients and families hold every belief and none.
Spiritual counseling must be provided in a manner consistent with the patient's and family's beliefs and desires, and only in accordance with their acceptance of the service.
The chaplain does not have to share the patient's tradition.
The rule expects reasonable efforts to facilitate visits by local clergy or pastoral counselors — the route for a patient who wants their own priest, imam, rabbi or pastor.
For patients with no religious tradition, the seat still belongs to them.
The spiritual needs assessment centers the patient's own needs, and counseling follows the patient's and family's beliefs and desires rather than the chaplain's.
The assessment is not a one-time intake step either.
The comprehensive assessment that carries the spiritual and bereavement pieces must be updated at least every 15 days, so the team's picture of a patient's spiritual needs keeps pace with the illness.
Families are inside the work as well.
The counseling obligation runs to the patient and the family, and the initial bereavement assessment looks at the family's social, spiritual and cultural needs.
Career growth
There is no single licensed route into the seat: federal hospice regulation sets no degree or certification standard for it.
Each hospice decides what it requires, and chaplains who want a credential build toward BCCI's Board Certified Chaplain — 72 graduate semester hours, four CPE units, a faith group endorsement and 2,000 hours of chaplain experience.
Chaplains who already hold BCC can add a specialist layer on top.
BCCI's advanced Palliative Care & Hospice certification is open to Board Certified Chaplains who complete the advanced certification process.
Experience can point to other seats inside the hospice too.
Its bereavement program must be supervised by a qualified professional with grief or loss experience or education (42 CFR 418.64(d)(1)).
Pay runs on a labeled proxy, because BLS has no "chaplain" occupation.
Clergy (21-2011) is the closest available group, and in BLS OEWS May 2025 clergy earned a national median of $29.24 an hour ($60,810 a year).
In the home health care services industry row, 10,920 clergy earned a median of $29.43 an hour ($61,210 a year).
The hospice chaplain salary page carries the full BLS tables.
On the same IDG sit adjacent careers: the registered nurse who is designated to coordinate each patient's care, and the social worker, marriage and family therapist or mental health counselor who holds the psychosocial seat.
Career information, not medical, legal or tax advice. Certification requirements are set by credentialing bodies and employers; confirm current BCCI requirements with the Association of Professional Chaplains and hospice staffing rules with CMS before you make a career or hiring decision.