Becker's Healthcare February 12, 2024
In 2024, Medicare Advantage plans must provide coverage for an inpatient admission when the admitting physician expects the patient to require hospital care for at least two-midnights, otherwise known as the two-midnight rule. Stays lasting less than two midnights must be treated and billed as outpatient.
The rule was included in the 2014 Medicare inpatient prospective payment system final rule. In 2023, CMS clarified in its final rule that MA plans must also follow the two-midnight rule, its case-by-case exception and the inpatient-only list, beginning in 2024.
“It’s going to be critical that hospitals work with their doctors to improve their documentation, not only to support the need for the patient to be in the hospital, but for how long...
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