CMS Explains How Hospitals Must Document Inpatient Status for Reimbursement

The Centers for Medicare and Medicaid Services (CMS) spelled out in detail what documentation hospitals require to claim a Medicare beneficiary under Part A inpatient status.

Last month CMS finalized IPPS regulations for the next fiscal year that requires hospitals to provide “physician certification of the medical necessity thats such services be provided on an inpatient basis.” Last week the federal agency released five pages of guidelines that specify exactly what form that documentation must be in and what it must include.

Each patient now requires two pieces of documentation:

• Physician Certification, which must be signed by a certified physician before the patient is discharged.
• Practitioner Order, which must be included as part of the Physician Certification, and “contains the instruction that the beneficiary should be formally admitted for hospital inpatient [or rehabilitation] care.”

Download a copy of the physician certification/practitioner order guidelines here (registration required):  (You must be logged in to download this file. Don't have an account? Register for free and you'll be returned to this page.)