US · guidance
CMS Pub. 100-04, ch. 30, § 200.3.1
Alterations to the IM
• The IM must remain two pages. The notice can be two sides of one page or one
side of two separate pages, but must not be condensed to one page.
• Hospitals may include their business logo and contact information on the top of
the IM. Text may not be shifted from page 1 to page 2 to accommodate large
logos, address headers, etc.
• Hospitals may include information in the optional “Additional Information”
section relevant to the beneficiary’s situation.
NOTE:
Including information normally included in the Detailed Notice of Discharge (DND) in
the “Additional Information” section does not satisfy a hospital’s responsibility to deliver
the DND, if otherwise required. See §200.4.5 ‘The Detailed Notice of Discharge (DND)’.
History
(Rev. 11210; Issued: 01-21-2022; Effective: 04-21-2022; Implementation: 04-21- 2022)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
60b32ab149f574ac95be430d0b24fb5db32d71a320f3d4ae896d79ca01d01f61
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