Frequently Asked Questions

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FAQ

Which patients should be included in the denominators calculated under the Observation Services Method and all ED Visits Method for the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs?

For the Observation Services method denominator includes patients admitted to the inpatient department (Place of Service (POS) 21) either directly or through the emergency department and patients who initially present to the emergency department (POS 23) and receive observaton services. Details on observation services can be found in the Medicare Benefit Policy Manual, Chapter 6, Section 20.6. Patients who receive observation services under both POS 22 and POS 23 should be included in the denominator. Patients who receive observation services outside of the emergency department (POS 23) could be included in the denominator, regardless of whether they initially presented in the emergency department, however the decision is left to the health care provider.
The all emergency department (ED) method includes all patients admitted to the inpatient department (POS 21) either directly or through the emergency department and all patients receiving services in the emergency department (POS 23).
Eligible hospitals and CAHs must select one of the methods for calculation and apply it consistently to denominators for measures. Providers cannot calculate the denominator of some measures using the "Observation Services method", while using the "All ED Visits method" for denominator of other measures. 5/12/2016 (FAQ2843)

(FAQ2843)

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