Please Note: There is no Medicare information on our corporate website. Please select a specific contract in the 'Search Within' box for Medicare related information.
© 2019 Palmetto GBA, LLC
We frequently update our articles to reflect the latest changes and updates to Medicare, and strongly recommend you visit this article at link below to confirm you have the latest version.
Printed Date: 9/22/2015
Answer: For long stay cases, prospective payment system (PPS) hospitals may submit interim bills to Medicare for every 60 days. The provider must submit an adjustment to cancel the original interim bill and re-bill the stay from the admission date through the discharge date.
For example, a beneficiary is inpatient for 130 days. The first claim is a 112 type of bill (TOB) for 60 days. An admission claim is for no less or no more than 60 days. The second claim is a 117 adjustment TOB for no more than 120 days. This adjustment cancels the admission 112 TOB and replaces it. The third claim submitted to report the discharge is also a 117 adjustment TOB for 130 days. A final discharge adjustment will be for no more than 180 days, if needed.
Reference: Centers for Medicare & Medicaid Services (CMS) Internet-Only Manual (IOM) Publication 100-04, Medicare Claims Processing Manual, Chapter 3, Section 50 - Adjustment Bills and Section 150.19 - Interim Billing (PDF, 2.22 MB)
We value your opinion and want to provide the highest-quality and most relevant Medicare knowledge possible. Please let us know if this article was helpful.
It didn't answer my question
This article was helpful
We’re glad we could help you today and appreciate your feedback. When you rate our articles as most helpful, we know that we are on the right track for providing you with important news and information.
We're sorry this article didn't help you today. We'll use your feedback to review this article to try to revise or expand it. Contact us with more feedback or a question on this topic.
Last Updated: 02/27/2019