Hospital articles
Critical access hospital (CAH) method II professional reassignment deadline is January 1
Beginning January 2, 2026, 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…
Critical access hospital (CAH) method II professional reassignments
CMS has issued new instructions concerning the Fiscal Intermediary Shared System (FISS) reason codes 31006 and 31007 for Method II critical access hospital (CAH) claims involving professional…
Guidance on hospital inpatient admission decisions
In this special edition article, CMS stresses the importance of staying informed of all CMS national inpatient hospital policy and national and local coverage determinations regarding making a…
Part A outpatient infusion and hydration services
Read this article for important billing information for outpatient infusion and hydration services.
Inpatient admitted prior to entitlement
There are special billing guidelines to follow when the beneficiary becomes entitled to Part A benefits in the middle of an inpatient stay.
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…
Long term care facility prospective payment system standard versus site neutral payment
For discharges on or after October 1, 2015, there are two separate payment categories for long term care hospital (LTCH) patients. This article provides those details.