
Here are some common hospital situations and a description of how Medicare will pay. But, your doctor must order such admission and the hospital must formally admit you in order for you to become an inpatient.Įach day you have to stay, you or your caregiver should always ask the hospital and/or your doctor, or a hospital social worker or patient advocate if you’re an inpatient or outpatient. An inpatient admission is generally appropriate when you’re expected to need 2 or more midnights of medically necessary hospital care. The decision for inpatient hospital admission is a complex medical decision based on your doctor’s judgment and your need for medically necessary hospital care. You can get observation services in the emergency department or another area of the hospital. Observation services are hospital outpatient services you get while your doctor decides whether to admit you as an inpatient or discharge you. In these cases, you're an outpatient even if you spend the night in the hospital. You're an outpatient if you're getting emergency department services, observation services, outpatient surgery, lab tests, or X-rays, or any other hospital services, and the doctor hasn't written an order to admit you to a hospital as an inpatient.The day before you're discharged is your last inpatient day. You're an inpatient starting when you're formally admitted to the hospital with a doctor's order.Your hospital status may also affect whether Medicare will cover care you get in a skilled nursing facility (SNF) following your hospital stay.

Your hospital status-whether you're an inpatient or an outpatient-affects how much you pay for hospital services (like X-rays, drugs, and lab tests).
