by Christine Woolstenhulme, QCC, QMCS, CPC, CMRS
July 17th, 2015
On July 1, 2015, CMS released proposed updates to the “Two-Midnight” rule regarding when inpatient admissions are appropriate for payment under Medicare Part A. These changes would continue CMS’ long-standing emphasis on the importance of a physician’s medical judgment in meeting the needs of Medicare beneficiaries. These updates were included in the calendar year (CY) 2016 Hospital Outpatient Prospective Payment System (OPPS) proposed rule.
Hospital Inpatient vs. Outpatient
Because of the way the Medicare statute is structured, the Medicare payment rates for inpatient and outpatient hospital stays differ.
Read the entire article: Fact Sheet: Two-Midnight Rule