NAPGCM Public Policy E-Newsletter: CMS Medicare Learning Network National Provider Call - Two Midnight Rule February 24, 2014

g>CMS Medicare Learning Network National Provider Call - Two Midnight Rule
Released to NAPGCM Membership on February 24, 2014

On August 2, 2013, CMS issued a final rule updating fiscal year 2014 Medicare payment policies and rates under the Inpatient Prospective Payment System (IPPS) and the Long-Term Care Hospital Prospective Payment System (LTCH PPS). The final rule, commonly known as the "2-Midnight Rule," modifies and clarifies the Medicare Administrative Contractor review of inpatient hospital and critical access hospital admissions for payment purposes. Under this final rule, surgical procedures, diagnostic tests and other treatments (in addition to services designated as inpatient-only), are generally appropriate for inpatient hospital admission and payment under Medicare Part A when the physician expects the beneficiary to require a stay that crosses at least two midnights and admits the beneficiary to the hospital based upon that expectation. CMS has released additional clarification here on the provisions of the final rule regarding the physician order and physician certification of hospital inpatient services.

The CMS Medicare Learning Network (MLN) has scheduled a National Provider Call to offer an overview of the inpatient hospital admission and medical review criteria that were released on August 2, 2013. The call will address frequently asked questions and answer questions from the public.

Thursday, February 27 - 2:30-4:00pm ET


  • Order and certification guidance
  • Case examples
  • Transfers
  • Question and answer session

Call Materials:

A link to the slide presentation will be posted here prior to the call. A link to the audio recording and written transcript of this call will be posted to this web page 2 weeks after the call.

For More Information:

Additional information on the 2-Midnight Rule can be found here.