The Use of Benefit's Exhaust (BE) Day as the Day of Discharge for Payment Purposes for the Inpatient Psychiatric Facility Prospective Payment System (IPF PPS) and Clarification of Discharge for Long Term Care Hospitals (LTCH) and the Allowance of No-Pay Benefits Exhaust Bills (TOB 110)
Under TEFRA, the Provider Statistical and Reimbursement (PS&R) Report used the benefits exhaust date as the discharge date. This changed when the Inpatient Psychiatric Facility Prospective Payment System (IPF PPS) became effective in 2005, and the 'actual' discharge date was used to define discharge. This Change Request (CR) redefines the policy to use the benefits exhaust date as the discharge date, and is consistent with the previous methodology. This CR also clarifies that the benefits exhaust date has always been considered the discharge date for payment purposes under LTCH PPS. It also allows IPFs and LTCHs to bill no-pay bills once benefits exhaust.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: April 27, 2007
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