The Nuances of the Two-Midnight Rule

by  David M. Glaser, Esq.
June 9th, 2022

When is a patient an inpatient?

A reader we’ll call Michelle asked a question during a recent Monitor Mondays broadcast — a question that encapsulated many of them: how can a Medicare patient who stays two midnights for a non-medical reason be an inpatient? 

For example, consider a patient who comes in for dehydration and gets IV fluids for one day, then seems ready for discharge, but the physician decides to watch the patient for one more day to check labs the next morning, because the patient does not have transportation to come back in for a lab check. Michelle says that “Medicare clearly states they do not pay for convenience, custodial (assistance), or delays in care.” I agree that Medicare doesn’t pay for convenience or custodial care, though I think there is a pretty good argument that delays in care can, in some instances, be covered. In any event, Michelle’s question is a great one, and on a topic I have been thinking about for two decades. This is one area where the esteemed Dr. Ronald Hirsch may not entirely agree with me, and I will be eager to hear his thoughts.


Read the entire article at RACmonitor by clicking here.

This article originally published on May 4, 2022 by RACmonitor.


The Nuances of the Two-Midnight Rule. (2022, June 9). Find-A-Code Articles. Retrieved from

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