The Centers for Medicare & Medicaid Services (CMS) has released an updated Medicare Outpatient Observation Notice (MOON) following approval by the Office of Management and Budget (OMB). The updated form is valid for three years and includes improvements to readability and design.
The new MOON form is effective immediately and is available in both English and Spanish on the CMS Beneficiary Notices Initiative (BNI) webpage. Beneficiary Notices Initiative (BNI) | CMS
Providers who currently have existing stock of the previous MOON version may continue using the expired form until April 20, 2026. All providers must transition to the updated MOON no later than April 20, 2026.
Provider Requirements:
All Medicare-participating hospitals and critical access hospitals (CAHs) are required to issue the MOON to Medicare beneficiaries—including Medicare Advantage/health plan enrollees—who are receiving outpatient observation services. The notice informs beneficiaries that they are hospital outpatients under observation and not admitted as inpatients.
For additional instructions on completing and issuing the MOON, please refer to Section 400, Chapter 30 of the CMS Claims Processing Manual (PDF).
- Begin using the updated MOON immediately where possible.
- Discontinue all use of the expired MOON form after April 20, 2026.
- Ensure staff are trained on the updated format and requirements.
- Confirm the correct version is being provided in the beneficiary’s preferred language (English or Spanish).
We appreciate your prompt attention to this update and your continued commitment to compliance with CMS beneficiary notice requirements.
Providers are encouraged to share this information with their staff. If you have any questions about this notice, please email Provider Relations at ProviderRelations@cfhp.com or call 210-358-6030. You can also contact your Provider Relations Representative directly.
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