US · guidance
CMS Pub. 100-04, ch. 1, § 150.3
Skilled Nursing Facility (SNF), Home Health Agency (HHA),
Hospice and Comprehensive Outpatient Rehabilitation Facility (CORF)
Claims Subject to Expedited Determinations
(Rev.13026, Issued: 12-27-24, Effective: 10-11-24, Implementation: 02-15- 25)
In short, SNFs, HHAs, hospices and CORFs must give notice to Medicare beneficiaries
of their right to expedited determinations when their period of covered care ends.
Expedited determinations allow beneficiaries to challenge/appeal their provider’s
decisions to discharge, whereas the standard appeal process available after a claim is
adjudicated allows beneficiaries to dispute payment denials. Detailed instructions
regarding expedited determination notices are found in chapter 30, section 260.
History
(Rev.13026, Issued: 12-27-24, Effective: 10-11-24, Implementation: 02-15- 25)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
01697d2926f5c48ecd0dc1a6f76b52faec5f09b2f8fbfbc3daa63f0bec2069f9
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