Updates
Updated 12/2/2025
The Centers for Medicare and Medicaid Services updated the Frequently Asked Questions (FAQs) to share additional information regarding Medicare Administrative Contractor inpatient short stay (hospital) medical reviews and provider education (i.e., patient status reviews). The latest FAQs can be found on the Inpatient Hospital Reviews FAQs page.
Updated 7/3/2025
Today, the Centers for Medicare and Medicaid Services has posted additional Frequently Asked Questions (FAQs) to provide more details to the public regarding transition of inpatient short stay (hospital) medical reviews and provider education (i.e., patient status reviews) to the Medicare Administrative Contractors.
The updated 7/3/2025 FAQs can be found on the Inpatient Hospital Reviews FAQs page.
Updated 5/22/2025
Today, the Centers for Medicare and Medicaid Services is notifying the public that Medicare Administrative Contractors (MACs) will perform short stay inpatient hospital medical reviews and provider education (i.e. patient status reviews). Those changes are detailed below:
Medicare Administrative Contractors: Beginning September 1, 2025, Inpatient Hospital short stay patient status reviews for acute care inpatient hospitals, long-term care hospitals, and inpatient psychiatric facilities will transition from the Beneficiary and Family Centered Care (BFCC) Quality Improvement Organizations’ (QIOs) (BFCC-QIO) to the MACs. MACs will perform reviews on a sample of Medicare pre-payment Part A claims as part of our current Targeted Probe and Educate (TPE) program. For more details on this program see: https://www.cms.gov/data-research/monitoring-programs/medicare-fee-service-compliance-programs/medical-review-and-education/targeted-probe-and-educate-tpe.
Beneficiary and Family Centered Care (BFCC) Quality Improvement Organizations’ (QIOs) (BFCC-QIO) are currently conducting reviews, through August of 2025.
The updated 5/22/2025 FAQs can be found on the Inpatient Hospital Reviews FAQs page.