Becker's Healthcare June 27, 2023
There are major changes afoot for Medicare Advantage plans and when they are required to cover inpatient services in hospitals for their members. The changes are likely to present challenges for hospitals and how physicians document inpatient care.
Six things to know about the two-midnight rule and how it applies to Medicare Advantage
1. In the 2014 Medicare inpatient prospective payment system final rule, CMS included a new regulation for hospitals and health systems: the two-midnight rule
2. Under the rule, inpatient admissions are covered for traditional Medicare beneficiaries who require more than a one-day stay in a hospital or who need treatment specified as inpatient only. Stays lasting less than two midnights must be treated and billed as outpatient.
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