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US · guidance

CMS Pub. 100-04, ch. 2, § 10.6

Hospitals May Require Prepayment for Noncovered Services

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

HO-303.3

With regard to noncovered services (e.g., personal comfort items, a private duty nurse),

the hospital may deny such services for which the beneficiary has not paid or offered

satisfactory assurance of payment if that is the hospital’s practice with nonbeneficiary

patients. For example, a private room or TV set need not be furnished to a patient who

requests it but is unable to prepay or offer the assurance of payment which is usually

required.

Where the individual has exhausted his/her covered inpatient hospital benefits, or cannot

supply satisfactory evidence of entitlement under Part A, providers are free to apply to

such persons the hospital’s usual policy with respect to requiring prepayment or other

assurance of payment where the patient has no insurance. In addition, for the

beneficiaries receiving covered inpatient services who are not enrolled for medical

insurance (Part B), the hospital can apply its usual policy on prepayment or assurance of

payment with regard to services of salaried physicians provided.

History

(Rev. 1, 10-01-03)

Provenance

Source
cms.gov
Retrieved
2026-08-25
Edition
iom-2026-08-25
Content hash
71665e10097554fece3baf6cc93588a26c4f02186ddf75b94b41cb995cef909d
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