Notice & Appeals Process for Original Medicare Beginning February 14, 2025:
Medicare beneficiaries with Original Medicare who have been reclassified by a hospital from an inpatient to an outpatient receiving observation services and meet additional criteria have a right to appeal their status change to a Beneficiary and Family Centered Care-Quality Improvement Organizations (BFCC-QIO).
Hospitals must deliver the Medicare Change of Status Notice (MCSN) to all beneficiaries eligible for the expedited determination process.
- To download the MCSN, please click on the appropriate link below in "Downloads".
- The MCSN is available in English, Spanish, Chinese, Vietnamese, and Korean.
- Full instructions for delivery of the MCSN and appeals process are available in Section 450, of Chapter 30 of the Medicare Claims Processing Manual, IOM 100-04, available below in "Related Links".
Full instructions for hospital billing related to MCSN appeals are available in Section 150 of Chapter 1 of the Claims Processing Manual, available below in "Related Links".
Questions?
Questions regarding the MCSN can be submitted at: https://appeals.lmi.org
Page Last Modified:
05/14/2025 08:33 PM