Medicare Benefit Policy Manual (Pub. 100-02), Ch. 5 § 10.2
Reserve Days Not Available Where Average Charges Do Not
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.