Healthcare Perspectives


COVID-19 changes: CMS updates 3-day rule

Mar 24, 2020

The Centers for Medicare & Medicaid Services (CMS) has waived the 3-midnight rule during the COVID-19 pandemic. Here’s what you need to know:

  • This update does not necessarily apply to every patient.
  • This rule applies to beneficiaries who are affected by the coronavirus, such as those who are “evacuated from a nursing home in the emergency area, discharged from a hospital (in the emergency or receiving locations) in order to provide care to more seriously ill patients, or need SNF care as a result of the emergency, regardless of whether that individual was in a hospital or nursing home prior to the emergency.”
  • The resident must meet skilled criteria.
  • This is retroactive to March 1, 2020.
  • Your billing needs to include the “DR” condition code to allow CMS to track these stays.

The official guidance can be found here


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Wipfli Editorial Team

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