US · guidance
CMS Pub. 100-04, ch. 30, § 450.4.1.1
Timeframes for Requesting an Expedited Determination
A beneficiary who receives an MCSN and disagrees with the status change may request
an expedited determination by the appropriate BFCC-QIO for the state where the
services were provided. The beneficiary may contact the BFCC-QIO by telephone or in
writing.
For timely requests:
The beneficiary must contact the BFCC-QIO before leaving the hospital for a timely
request.
For untimely requests:
The beneficiary may contact the BFCC-QIO at any time, including after a related claim
has been filed with the Medicare Administrative Contractor (MAC).
History
(Rev. 12934; Issued: 10-31-24; Effective: 11-15-24; Implementation: 02-14-25)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
34dda33cc11c582dd0eee32ffcecb516f9d7ecc3d403e9e1f89f398e117a0e04
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