Non-Physician Outpatient Services Provided Before or During Inpatient Stays: Bill Correctly

In a recent report, the Office of Inspector General (OIG) determined that Medicare made incorrect payments for non-physician outpatient services provided shortly before or during inpatient stays. Review the FAQs on the 3-Day Payment Window for Services Provided to Outpatients Who Later Are Admitted as Inpatients (PDF) MLN Matters Article to bill correctly for these services. Additional resources:

• Medicare Benefit Policy Manual, Chapter 6 (PDF), Section 20.4
• Medicare Claims Processing Manual, Chapter 12 (PDF), Sections 90.7, 90.7.1
• CY 2012 Medicare Physician Fee Schedule Final Rule
• Medicare Does Not Pay Acute-Care Hospitals for Outpatient Services They Provide to Beneficiaries in a Covered Part A Inpatient Stay at Other Facilities (PDF) MLN Matters Article