HI 00401.230 Definition of Emergency Services Hospital
An emergency services hospital is a nonparticipating hospital which meets the requirements
of the law’s definition of a “hospital” relating to full-time nursing services and licensure under State or applicable local
law. (A Federal hospital need not be licensed under State or local licensing laws
to meet the definition of emergency hospital.) In addition, the hospital must be primarily
engaged in providing, under the supervision of doctors of medicine or osteopathy,
services of the type that HI
00401.225 describes in defining the term hospital, and must be primarily engaged in providing
skilled nursing care and related services for patients who require medical or nursing
care. (See requirement A. of the definition of an SNF in HI 00401.260.) Psychiatric and tuberculosis hospitals that meet the above hospital requirements
can qualify as emergency hospitals. Inpatient hospital services and related physician
and ambulance services furnished outside the United States are covered under certain
The determination of whether an emergency existed is made by the appropriate intermediary.
Payment of claims for emergency is also made by intermediaries designated by CMS.
A stay in a hospital meeting these requirements meets the prior stay requirements
for coverage of extended care services and, prior to 7 /1/81, for Part A home health