As you may know, hospitals and critical access hospitals (CAHs) are required by the Centers for Medicare and Medicaid Services (CMS) and the Notice of Observation Treatment and Implication for Care Eligibility (NOTICE) Act to provide written notification and a verbal explanation to Medicare members who receive observation services in an outpatient setting for more than 24 hours. The notification must be provided to members for acknowledgment using the Medicare Outpatient Observation Notice (MOON) no later than 36 hours after observation services have been initiated. 

The MOON is a standardized CMS form that informs Medicare beneficiaries (including Medicare Advantage enrollees) that they are outpatients under observation, not inpatients. CMS recently updated the form, which is effective now through Feb. 28, 2029. Providers can continue to use the previous version of the MOON until April 20, 2026, at which time they must transition to use of the new version of the form. Additional MOON information and instructions can be found on the Beneficiary Notices Initiative (BNI) section of the CMS website. 

To learn more about Tufts Health Plan’s Observation Program and the MOON requirement, refer to the Observation Program chapter of the Tufts Health Plan Senior Products Provider Manual.