HI 00601.280 Inpatient Extended Care Services Counting Toward Maximums

Extended care services count toward the maximum number of benefit days payable per benefit period only if:

A. Payment for the services is made, or

B. Payment for the service would be made if a request for payment were properly filed and if the physician certified that the services were medically necessary. When payment cannot be made because of the extended care coinsurance requirement, the day(s) used in satisfying this requirement nevertheless count toward the beneficiary's maximum days of extended care.