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Hospital, Emergency, and Ambulance Services
Effective date
Jan 1, 2027
Identified
Nov 7, 2026
Summary
UnitedHealthcare's Medicare Advantage medical policy for hospital, emergency, and ambulance services was revised in the November 2026 bulletin, effective 2027-01-01. Inpatient hospital coverage rationale now links to the Two Midnight Rule Fact Sheet in place of the older CMS FAQ on midnight inpatient admission guidance, and the outpatient hospital section points to the CY 2026 OPPS/ASC final rule. Billing teams should update their internal reference materials and admission-status and outpatient coding guidance to match the revised links.
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What to do
Action · 1 steps
01By 2027-01-01: Billing team should update internal admission-status and outpatient hospital billing references to point to the Two Midnight Rule Fact Sheet and the CY 2026 OPPS/ASC final rule, retiring the removed CMS FAQ link, and share the updated references with providers and front desk staff who handle inpatient versus observation status decisions for Medicare Advantage members.
Original notice
Hospital, Emergency, and Ambulance Services
uhcprovider.com · Always check the source before changing claims.