Hospital articles
Hospital off-campus outpatient department reporting requirements
Effective July 6, 2026, outpatient claims with type of bills (TOB) 13X or 14X will be returned to provider (RTP) for reason code 34554 if modifier ER, PO, or PN is billed on all service lines, and…
Checklist: Inpatient admission documentation
This checklist is an aid to assist providers with responding to medical record documentation requests.
Checklist: Inpatient admission documentation
This checklist is an aid to assist providers with responding to medical record documentation requests.
Inpatient hospital entitlement changes
When a patient enrolls in or disenrolls from a Medicare Advantage plan during his/her inpatient stay, the following factors will determine whether to bill the Medicare Advantage plan and/or original…
Critical access hospital (CAH) method II professional reassignments
CAH Part A Method II claims for professional services will return to provider (RTP) if a reassignment isn’t in PECOS. Watch the on-demand learning video, "CAHs Method II Professional Reassignments,"…
Method II critical access hospitals: Reprocessing certain claims with reassigned billing rights
Breaking news for critical access hospitals (CAHs): CMS has directed MACs to immediately turn off reason codes 31006 and 31007 to give providers time to submit all method II reassignments to their…
Hospital: Additional resources
Information pertaining to inpatient and outpatient hospital resources.
Hospital CMS internet-only manuals (IOMs)
Information pertaining to Part A hospitals - Centers for Medicare & Medicaid Services (CMS) internet-only manuals (IOMs).
Availability of the list of essential medicines considered to be in shortage for the purposes of the recently finalized separate IPPS payment for establishing and maintaining access to essential medicines
In the fiscal year 2025 IPPS and LTCH final rule, CMS finalized a separate payment for establishing and maintaining access to essential Medicines. Read this article to learn more.