US · guidance
CMS Pub. 100-01, ch. 5, § 10.2
Admission of Medicare Patients for Care and Treatment
participate in the health insurance program, contemplates that such provider will admit
Medicare beneficiaries for care and treatment, and upon admission, will provide them
with such services as are ordinarily furnished by the provider to its patients generally.
A provider may have restrictions on the types of services it makes available and/or the
types of health conditions it accepts, or may establish other criteria relating to the
admission of persons for care and treatment. However, the law does not contemplate that
such restrictions or criteria will apply only to Medicare beneficiaries as a class. It does
contemplate, however, that if such restrictions or criteria apply to Medicare beneficiaries,
they will be applied in the same manner in which they are applied to all other persons
seeking care and treatment by the provider. Thus, a provider admission or patient policy
or practice which is not consistent with the objective contemplated in the law may be
used by CMS as a basis for termination of the agreement for cause (see the regulations at
42 CFR 489.53(a)(2), and also see Pub. 100-04, Medicare Claims Processing Manual,
chapter 1, §30.1.3).
History
(Rev. 120, Issued: 11-02-18, Effective: 12- 04-18, Implementation: 12- 04-18 The participation of a provider of services, which voluntarily files an agreement to
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
12813263a96844d6bdcc34044942d90d838a6a669bd19608737082e974b065d3
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