CHA News

CMS Provides Additional Guidance on Beneficiary Observation Status Appeals

What’s happening: The Centers for Medicare & Medicaid Services (CMS) has issued additional information, including billing instructions, for the Medicare Change of Status Notifications (MCSN).   

What else to know: Beginning Feb. 14, CMS will require giving MCSNs to patients who are reclassified from inpatient to observation (outpatient) status.   

In a recently issued MLN Matters article, CMS provides additional information and instructions, including which patients are eligible to appeal, the quality improvement organization’s (QIO) role in the appeals process, and claims processing based on the QIO decision.