Update to the Medicare Three-Day Payment Window Rule


On October 29, 2010, the Centers for Medicare & Medicaid Services (CMS) issued a Transmittal entitled “Clarification of Payment Window for Outpatient Services Treated as Inpatient Services” (Transmittal 796), which provides instruction on how to submit claims for outpatient services furnished within three days of an inpatient admission that are unrelated to the admission. This long-awaited instruction flows from § 102 of the Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010 (Pub. L. 111-192) (the Act), which changed the definition of admission-related non-diagnostic services furnished on the date of admission or during the three calendar days prior to the date of admission (the “3-day payment window”)1 effective for services furnished on or after June 25, 2010. Section 102 of the Act also requires that all admission-related non-diagnostic services be bundled with the claim for the related inpatient stay. The Act left unclear, however, what constitutes services “related” to an admission.

Please see full article below for more information.

LOADING PDF: If there are any problems, click here to download the file.

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

© Katten Muchin Rosenman LLP | Attorney Advertising

Written by:


Katten Muchin Rosenman LLP on:

Readers' Choice 2017
Reporters on Deadline

"My best business intelligence, in one easy email…"

Your first step to building a free, personalized, morning email brief covering pertinent authors and topics on JD Supra:

Sign up to create your digest using LinkedIn*

*By using the service, you signify your acceptance of JD Supra's Privacy Policy.

Already signed up? Log in here

*With LinkedIn, you don't need to create a separate login to manage your free JD Supra account, and we can make suggestions based on your needs and interests. We will not post anything on LinkedIn in your name. Or, sign up using your email address.