CMS Clarifies Hospital Inpatient Admission, Medical Review Rules

CMS has issued guidance to help providers interpret the agency’s new requirements for patient admissions and medical review criteria for hospital inpatient services under Medicare Part A.

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CMS’ five-page guidance document clarifies what types of practitioners can furnish orders for inpatient services and what information must be included in those orders.

It also spells out the timing restraints for physician certification of medical necessity, which is required for reimbursement under Medicare Part A. The certification must be completed, signed, dated and documented in the medical record prior to patient discharge, except in outlier cases.
 
View the complete guidance report.

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