Annual Reminder: Medicare Outpatient Observation Notice Required

December 13, 2018

As of March 8, 2017, hospitals and Critical Access Hospitals (CAH) must give the standardized Medicare Outpatient Observation Notice (MOON) to people who receive Medicare benefits and are observed as outpatients for more than 24 hours. This includes people with Blue Cross Medicare Advantage (PPO)SM, Blue Cross Medicare Advantage (HMO)SM and Blue Cross Medicare Advantage Dual Care (HMO SNP)SM health plans.

This notice lets people know why they are not inpatients and what their cost sharing and hospital coverage will be. It must be explained verbally and signed no later than 36 hours after observation begins or sooner if patients are admitted, transferred or released. Patients must sign to confirm they received and understand the notice. If they say no, the staff member who gave the notice must certify that it was presented.

Centers for Medicare & Medicaid Services (CMS) developed a standardized notice along with instructions on how to complete and they are available on the CMS Website; Medicare Outpatient Observation Notice Learn more about third-party links. The finalized, OMB-approved Medicare Outpatient Observation Notice (MOON) / CMS-10611, and form instructions are now available. They can be found at Medicare Outpatient Observation Notice form and instructions Learn more about third-party links

Thank you for your continued participation. If you have any questions or if you need additional information, please contact your BCBSTX Network Management Representative

The information provided here is only intended to be a summary of the law that has been enacted and is not intended to be an exhaustive description of the law or a legal opinion of such law. If you have any questions regarding the law mentioned here, you should consult with your legal advisor.