Medicare Benefit Policy Manual (Pub. 100-02), Ch. 5 § 10.2

Reserve Days Not Available Where Average Charges Do Not

Last amended: 2003Year: 2003Length: 126 wordsOfficial source
10.2 - Reserve Days Not Available Where Average Charges Do Not Exceed One-Half Inpatient Hospital Deductible (Rev. 1, 10-01-03) A3-3106.C, HO-219.C A beneficiary will be deemed to have elected not to use the lifetime reserve days where the average daily charge for covered services furnished during a lifetime reserve days billing period is equal to or less than the coinsurance amount for the lifetime reserve days. Such days are treated as noncovered days rather than potential lifetime reserve days since the beneficiary would be required to pay for all of the hospital charges regardless of his or her election and therefore would not benefit from use of lifetime reserve days. This rule applies to hospitals not paid under PPS. See §30 for deemed election under PPS.
Medicare Benefit Policy Manual (Pub. 100-02), Ch. 5 § 10.2: Reserve Days Not Available Where Average Charges Do Not | Justis AI