What is the Two-Midnight rule in Medicare?

Whether or not to admit you as an inpatient to a hospital is a decision made by your doctor after reviewing your medical situation, and they decide whether it is necessary to admit you to the hospital. According to Medicare, an inpatient admission is generally appropriate when you’re expected to need 2 or more midnights of medically necessary hospital care. Your doctor must order the hospital admission, and the hospital must formally admit you to be considered an inpatient.

Whether you are classified as an inpatient or an outpatient impacts the out-of-pocket costs (deductibles, copays, and coinsurance), you have to pay for hospital services (X-rays, drugs, and lab tests). Your hospital status (inpatient vs. outpatient) may also affect if Medicare will cover care in a skilled nursing facility (SNF) after your hospital stay.

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