PDF Version
TO: Hospital Providers
RE: Hospital Inpatient Care Criteria
Effective October 1, 2024,
the document titled Inpatient Care Criteria has been updated. Alabama Medicaid
utilizes the Adult
and Pediatric Inpatient Care Criteria, Severity of Illness (SI) / Intensity of
Service (IS), for utilization review, billing, and reimbursement purposes for
inpatient hospital admissions and concurrent stays. This document may be
accessed here: https://medicaid.alabama.gov/content/4.0_Programs/4.4_Medical_Facilities/4.4.1_Hospital_Services.aspx.
Additional information
regarding inpatient admissions is in Chapter 19 of the Provider Billing
Manual.
Providers with policy questions may contact Medical Services at medicalservices@medicaid.alabama.gov.
The Current Procedural Terminology (CPT) and Current Dental Terminology
(CDT) codes descriptors, and other data are copyright © 2024
American Medical Association and © 2024 American Dental Association (or such other date publication of CPT and
CDT). All rights reserved. Applicable FARS/DFARS apply.