State & FederalMedicare AdvantageApril 1, 2022

Reimbursement policy update: Inpatient Readmissions

Effective July 1, 2022, when a member is readmitted within 30 days as part of a planned readmission and/or placed on a leave of absence, the admissions are considered to be one admission, and only one diagnosis-related group (DRG) will be reimbursed.

 

For additional information, please review the Inpatient Readmission reimbursement policy at https://www.anthem.com/ca/provider/medicare-advantage.

ABCCRNU-0213-21