Question

In what hospital setting does Medicare's 3-day payment window become 1-day window instead?

-Acute Care Hospital
-Hospital Day Surgery Unit
-Psychiatric Hospitals
-Observation Unit

Answer 1

Medicare's 3-day payment window reduces to a 1-day window for services provided in a Hospital Day Surgery Unit that is part of a different hospital where the patient is admitted within a day of the outpatient services.

Step-by-step explanation:

The Medicare 3-day payment window rule typically applies to services provided at an Acute Care Hospital, where services related to an admission are bundled into the inpatient payment when they occur within three days of the admission (or one day in non-rural, non-teaching hospitals). However, this question refers to a special case where the 3-day window reduces to a 1-day window. The 1-day payment window is applicable to a Hospital Day Surgery Unit that is part of a different hospital where the patient is admitted within one day of the outpatient diagnostic or therapeutic services provided. This rule does not apply to Psychiatric Hospitals or the Observation Unit, as these settings have different regulations governing Medicare payments.