4. Charges for deluxe private room

A beneficiary who needs a private room may be assigned to any of the provider’s private rooms.

Although they do not have the right to insist on the private room of their choice, their preferences are given the same consideration as if they were paying all provider charges themselves. The program does not, under any circumstances, pay for personal comfort items. Thus, the program does not pay for deluxe accommodations and/or services; these include a suite, or a room substantially more spacious than is required for treatment, or specially equipped or decorated, or serviced for the comfort and convenience of persons willing to pay a differential for such amenities. If they (or their representative) requests such deluxe accommodations, the provider advises them that there will be a charge, not covered by Medicare, of a specified amount per day and may charge them that amount for each day they occupy the deluxe accommodations.

The beneficiary may not be charged such a differential in private room rates if that differential is based on factors other than personal comfort items. Such factors might include differences between older and newer wings, proximity to lounge, elevators or nursing stations, desirable view, etc. Such rooms are standard one-bed units and not deluxe room for purposes for these instructions, even though the provider may call them deluxe and have a higher customary charge for them. No additional charge may be imposed upon the beneficiary who is assigned to a room which may be somewhat more desirable because of these factors.

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4. Charges for deluxe private room

Official source

A beneficiary who needs a private room may be assigned to any of the provider’s private rooms.

Although they do not have the right to insist on the private room of their choice, their preferences are given the same consideration as if they were paying all provider charges themselves. The program does not, under any circumstances, pay for personal comfort items. Thus, the program does not pay for deluxe accommodations and/or services; these include a suite, or a room substantially more spacious than is required for treatment, or specially equipped or decorated, or serviced for the comfort and convenience of persons willing to pay a differential for such amenities. If they (or their representative) requests such deluxe accommodations, the provider advises them that there will be a charge, not covered by Medicare, of a specified amount per day and may charge them that amount for each day they occupy the deluxe accommodations.

The beneficiary may not be charged such a differential in private room rates if that differential is based on factors other than personal comfort items. Such factors might include differences between older and newer wings, proximity to lounge, elevators or nursing stations, desirable view, etc. Such rooms are standard one-bed units and not deluxe room for purposes for these instructions, even though the provider may call them deluxe and have a higher customary charge for them. No additional charge may be imposed upon the beneficiary who is assigned to a room which may be somewhat more desirable because of these factors.