Billing Instructions: Expedited Determinations Based on Medicare Change of Status Notifications

Related CR Release Date: December 27, 2024
MLN Matters Number: MM13918
Effective Date: October 11, 2024
Related Change Request (CR) Number: CR 13918
Implementation Date: February 15, 2025
Related CR Transmittal Number: R13026CP

CR 13918 tells you about:

  • When patients are eligible to appeal a hospital status change
  • Quality Improvement Organization (QIO) role in the appeals process
  • Claims processing based on QIO appeal decision

Make sure your billing staff knows about these changes.

View the complete CMS Medicare Learning Network (MLN) Matters (MM)13918.

Last Updated Jan 08 , 2025