FFS & MA IM/DND

Hospitals are required to deliver the Important Message from Medicare (IM), formerly CMS-R-193 and now CMS-10065, to all Medicare beneficiaries (Original Medicare beneficiaries and Medicare Advantage plan enrollees) who are hospital inpatients. The IM informs hospitalized inpatient beneficiaries of their hospital discharge appeal rights. A Detailed Notice of Discharge (DND) is given only if a beneficiary requests an appeal.  The DND explains the specific reasons for the discharge. 

Full instructions for the Original Medicare, also known as Fee for Service (FFS), process are available in Section 200, of Chapter 30 of the Medicare Claims Processing Manual, available below in "Downloads".

Current versions of the Important Message from Medicare (IM), Form CMS-10065, and the Detailed Notice of Discharge (DND), Form CMS-10066, are posted below under "Downloads".

Full instructions for Medicare health plans are available in Section 100 of the Parts C & D Enrollee Grievances, Organization/Coverage Determinations, and Appeals Guidance, available below in “Downloads.” 

The notices, including Spanish versions, are available below under “Downloads.”

3/17/2026: The Office of Management and Budget (OMB) have approved the Important Message from Medicare (IM) and Detailed Notice of Discharge (DND).  CMS is notifying the industry through our website, the Health Plan Management System (HPMS), and the Medicare Learning Network. While no changes were made to the IM and DND delivery or timeframe requirements, CMS made readability and design improvements for consistency with other Medicare notices. The updated versions of the IM and DND are effective now and expire March 31, 2029.  Providers may continue using the expired versions of the IM and DND until May 15, 2026, but must transition to the approved forms no later than that date. 

Questions?

Questions regarding the IM and DND can be submitted at: https://appeals.lmi.org