The Medicare inpatient-only list refers to procedures and services that CMS has identified as typically only provided in the inpatient setting and therefore not paid under OPPS.
The designation of inpatient-only list by Medicare requires an inpatient admission for payment even though the provider may feel the procedure can be safely performed in an outpatient setting.
Inpatient-only procedures are those that CMS has determined providers must perform on an inpatient basis because they are invasive and require at least 24 hours of postoperative recovery time or monitoring. These procedures are also performed on patients with serious underlying conditions
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