Physical, occupational, and speech therapy are in their essence palliative, in that function and quality of life are maximized, rather than disease or disability cured. It is important to understand all aspects of the new hospice and palliative care niche to develop a successful and rewarding clinical practice. This course begins with the history and development of current methods, identification of philosophy, goals, organizational structure, and financial issues of the Medicare Hospice Benefit, the primary payer that mandates such care. The unique and essential roles of rehabilitative therapies are outlined, addressing practice patterns, team roles, equipment, and referral management. The course concludes with a review of cost neutral strategies for hospice therapy program development and optimal organizational success.