US · guidance
CMS Pub. 100-02, ch. 13, § 40.5
3-Day Payment Window
Medicare’s 3-day payment window applies to outpatient services furnished by a hospital
(or an entity that is wholly owned or wholly operated by the hospital). The statute
requires that hospitals’ bundle the technical component of all outpatient diagnostic
services and related non-diagnostic services (e.g., therapeutic) with the claim for an
inpatient stay when services are furnished to a Medicare beneficiary in the 3 days (or, in
the case of a hospital that is not a subsection (d) hospital, during the 1-day) preceding an
inpatient admission in compliance with section 1886 of the Act.
RHCs and FQHC services are not subject to the Medicare 3- day payment window
requirements.
For additional information on the 3 day payment window, see
http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNMattersArticles/downloads/MM7502.pdf
History
(Rev.239, Issued: 01-09-18, Effective: 1-22-18, Implementation: 1-22-18)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
1b3fd29f69999255a5bcdf2769afcfd37edf7076fe6bd325f529900fd727bcb3
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