Availability of Reserve Days Where Psychiatric Limitations Are

10.3 - Availability of Reserve Days Where Psychiatric Limitations Are Involved (Rev. 1, 10-01-03) A3-3106.D, HO-219.D A beneficiary's reserve days are not available to the extent that he or she is subject to the 150-day psychiatric hospital reduction provision, i.e., where the beneficiary has been in a psychiatric hospital during the l50-day period immediately preceding the first day of entitlement to hospital insurance benefits and is still in a psychiatric hospital on the first day of entitlement. (See the Medicare Benefit Policy Manual, Chapter 4, §10.) The reserve days are available, however, if such a beneficiary receives nonpsychiatric services in a general hospital or if the beneficiary starts a new benefit period. The reserve days are also not available to a beneficiary who is in a psychiatric hospital after using l90 days of inpatient psychiatric hospital care during his or her lifetime. (See the Medicare Benefit Policy Manual, Chapter 4, §50.)