US · guidance
CMS Pub. 100-10, ch. 9, § 9055.2
Exceptions to Denial of Medicare Payment (Exclusion) –
Regulatory Requirements
(Rev. 24, Issued: 02-12-16, Effective: 03-14-16, Implementation: 03-14-16)
Unless the HHS Secretary determines that the health and safety of beneficiaries warrants
the exclusion taking effect earlier, payment may be made for services or items provided up
to thirty (30) days after the effective date of exclusion for:
• Inpatient hospital or skilled nursing services or items furnished to a beneficiary
who was admitted before the effective date of the exclusion;
• Home health services and hospice care items furnished under a plan established
before the effective date of the exclusion; or
• Any health care items that a practitioner, provider, or supplier orders from an
excluded manufacturer before the effective date of the exclusion and delivered
within thirty (30) days of the effective date of such exclusion.
History
(Rev. 24, Issued: 02-12-16, Effective: 03-14-16, Implementation: 03-14-16)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
941b5d63c75620b4c02c75031ae3b5d0ec576379c74500a2cceccd76db13ca12
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