Skip to main content
U.S. flag

An official website of the United States government

Return to Search

Medicare Beneficiary Notices Initiative (BNI) Hospital Discharge Appeal Notices

Guidance for hospitals regarding the required Important Message from Medicare (IM), formerly CMS-R-193 and now CMS-10065, that must be provided to all Medicare beneficiaries (Original Medicare beneficiaries and Medicare Advantage plan enrollees) who are hospital inpatients.

Final

Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: September 25, 2020

January 23, 2023 - The IM/DND have received OMB approval. The new versions must be used no later than April 27, 2023.

Hospitals are required to deliver the Important Message from Medicare (IM), formerly CMS-R-193 and now CMS-10065, to all Medicare beneficiaries (Original Medicare beneficiaries and Medicare Advantage plan enrollees) who are hospital inpatients. The IM informs hospitalized inpatient beneficiaries of their hospital discharge appeal rights. A Detailed Notice of Discharge (DND) is given only if a beneficiary requests an appeal.  The DND explains the specific reasons for the discharge. 

Full instructions for the Original Medicare, also known as Fee for Service (FFS), process are available in Section 200, of Chapter 30 of the Medicare Claims Processing Manual, available below in "Downloads".

Current versions of the Important Message from Medicare (IM), Form CMS-10065, and the Detailed Notice of Discharge (DND), Form CMS-10066, are posted below under "Downloads".

Full instructions for Medicare health plans are available in Section 100 of the Parts C & D Enrollee Grievances, Organization/Coverage Determinations, and Appeals Guidance, available below in “Downloads.” 

The notices, including Spanish versions, are available below under “Downloads.”

Questions?

Questions regarding the IM and DND can be submitted at: https://appeals.lmi.org

HHS is committed to making its websites and documents accessible to the widest possible audience, including individuals with disabilities. We are in the process of retroactively making some documents accessible. If you need assistance accessing an accessible version of this document, please reach out to the guidance@hhs.gov.

DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.