Medicare cost sharing and post hospital coverage can depend on whether a beneficiary was admitted to the hospital and received treatment as an inpatient or received treatment as an outpatient. Some beneficiaries are surprised to learn that despite having received treatment overnight in a hospital bed during their hospital stay they were never formally admitted but instead were under observation as an outpatient. The Two-Midnight Rule implemented by the Centers for Medicare & Medicaid Services (CMS) is intended to clarify when an inpatient admission is considered medically necessary.
Date of Report: July 23, 2015
Order Number: IF10264
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