Corporate

April 22, 2015 - Revised: 08.09.18

Inpatient Only Services

"Inpatient only" services are generally, but not always, surgical services that require inpatient care because of the nature of the procedure, the typical underlying physical condition of patients who require the service, or the need for at least 24 hours of postoperative recovery time or monitoring before the patient can be safely discharged.

The policies related to inpatient only services are located in the CMS Medicare Claims Processing Manual (Pub. 100-04), chapter 4, section 180.7External PDF.

A list of inpatient only services is updated annually in the Hospital Outpatient Prospective Payment System (OPPS) Final Rule and can be found in either of the following:

  • Addendum E:
  • Addendum BExternal Website is updated and published quarterly.
    • Select the applicable quarter and calendar year.
    • Inpatient-only services are assigned status indicator C.
    • To view the list of codes assigned status indicator C:
      • Select "Data" and then "Sort".
      • Select "Sort by" and then "SI".
      • Highlight Column C and then Ctrl+F.
      • Type "c" in the "Find what" field and then click "Find Next".

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