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US · guidance

CMS Pub. 100-02, ch. 3, § 20.1.3

Discharge or Death on First Day of Entitlement or Participation

activein force · 2026-08-25 – presentas-observed

A3-3103.4, A3-3135.4, HO-216.4, SNF-242.4

For SNF services, the cost of such services has been built into the SNF PPS base. This

makes the PPS per diem somewhat higher than it would otherwise have been for all of the

preceding SNF days that Part A does cover, even though the day of discharge itself is not

a covered Part A day:

• A patient is admitted prior to the first day of entitlement and dies or is discharged

from a participating hospital on the first day of entitlement; or

• A patient in a noncovered stay in a nonparticipating hospital dies or is discharged

on the first day the hospital becomes a participating hospital. For a late discharge

on such a day, the rules in §20.1.1 will be followed.

For SNF services, Medicare does not pay for accommodations on the day of discharge or

death. Medicare pays for ancillary services (under Part A) when a patient dies or is

discharged on the first day a facility becomes a participating facility and the other

requirements for coverage of extended care services are met.

Although a day of utilization is not counted in these situations, a benefit period begins

and any charges for covered services are applied against the inpatient hospital deductible.

History

(Rev. 1, 10-01-03)

Provenance

Source
cms.gov
Retrieved
2026-08-25
Edition
iom-2026-08-25
Content hash
64a3018f02c3b0abba2c1bc11f3eecf6d47fcfd883c19e0e00b77e3d0febc4c6
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