Hospital articles
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…
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…
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,"…
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.
Inpatient hospital short stay reviews
Inpatient hospital short stay patient status reviews for acute care inpatient hospitals, long-term care hospitals, and inpatient psychiatric facilities.
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.
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.