Implement and educate: CMS continues to clarify two-midnight rule

In the final payment rule for fiscal year 2014, CMS codified a “Two-Midnight Rule” that applies to surgical procedures, diagnostic tests, and other treatments provided in acute care inpatient hospital facilities, long-term care hospitals, critical access hospitals, and inpatient psychiatric facilities.This rule establishes both a benchmark for physicians to determine when an inpatient admission will likely be viewed as appropriate for Part A payment, and a presumption for medical review contractors to use in conducting post-payment audits. For the benchmark, the rule specifies that Part A payment is generally appropriate (Read more...)

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