Certified Revenue Cycle Representative (CRCR) Practice Exam

How long do Medicare beneficiaries remain in the same benefit period?

1. Up to hospitalization discharge

2. Until free from hospitalization or skilled nursing facility for 60 days

3. Each calendar year

4. Up to 60 days

The correct answer is: Until free from hospitalization or skilled nursing facility for 60 days

Medicare beneficiaries remain in the same benefit period until they have been free from hospitalization or skilled nursing facility care for 60 consecutive days. This is important because Medicare uses the benefit period to determine eligibility for coverage for hospital and skilled nursing facility services. A benefit period begins the day a beneficiary is admitted to a hospital or skilled nursing facility and ends when they have not received any inpatient care for 60 days. Understanding this period is crucial as it impacts the kind of services that beneficiaries can receive and the associated costs. After the 60-day period, if the beneficiary requires additional inpatient services, a new benefit period will start, potentially leading to new deductibles and coverage conditions.