US · guidance
CMS Pub. 100-04, ch. 30, § 400.3.2
Completing the MOON
Hospitals must use the OMB-approved MOON (CMS-10611). Hospitals must type or
write the following information in the corresponding blanks of the MOON:
• Patient name;
• Patient number; and
• Reason patient is an outpatient.
History
(Rev. 3698, Issued: 01-27-17, Effective: 02-21-17; Implementation: 02-21-17)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
15b03a85c8b20bee8b2a4386439f9e3c1aef6a5a7f2fc0ac2d6027544ba1c689
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