Appealing a skilled-nursing or rehab discharge

If a rehab center, skilled-nursing facility, or hospital tells you Medicare coverage is ending and you don’t feel ready to leave, you have the right to a same-day fast-track appeal— and you stay covered while it’s reviewed. It’s free.

Time-sensitive — act today

Call the appeal number on your notice as soon as you get it. The notice itself says: “You must ask for a timely appeal no later than noon of the day before the above date” (Form CMS-10123-NOMNC), where the date is the day your coverage ends. The regulation puts it as “no later than noon of the calendar day following receipt of the provider’s notice” (42 CFR §405.1202(b)(1)). If you ask in time, “the provider may not bill the beneficiary for any disputed services until the expedited determination process … has been completed” (42 CFR §405.1202(g)).

What to do, step by step

1Get the notice in writing. The facility must give you a written “Notice of Medicare Non-Coverage” (Form CMS-10123) “no later than 2 days before the proposed end of the services” (42 CFR §405.1200(b)(1)). It lists the date coverage ends, your deadline, and the phone number for the Quality Improvement Organization (the BFCC-QIO) that reviews these appeals.
2Call that number and ask for a “fast appeal.” Use the phone number printed on your notice, “in writing or by telephone.” Call before the deadline printed on the notice; a late request still gets reviewed, but the 72-hour clock and the billing protection “do not apply” (42 CFR §405.1202(b)(4)).
3Say you don’t agree the stay should end. You don’t need medical language. “I’m being discharged and I don’t think I’m ready. I want to file a fast appeal.” The reviewer will ask the facility for your records; the burden of proof is on the provider.
4Stay put while they review. For a skilled-nursing, home health, rehab facility or hospice termination the reviewer must decide “no later than 72 hours after receipt of the request” (42 CFR §405.1202(e)(6)). While it is pending, the provider may not bill you for the disputed days if you asked on time.
5If they say no, you can ask for a second look. You may ask for an expedited reconsideration “by no later than noon of the calendar day following” the reviewer’s decision (42 CFR §405.1204). The decision letter states how. Your doctor can add a letter of medical necessity at that stage.

Works for both kinds of Medicare. Fast-track appeal rights for a skilled-nursing or rehab discharge exist under both Original Medicare (42 CFR §§405.1200–405.1206) and Medicare Advantage (42 CFR §§422.624–422.626). The Medicare Advantage rule words the deadline as “by noon of the first day after the day of delivery of the termination notice” and the reviewer decides “by close of business of the day after it receives the information necessary.” Your notice tells you which reviewer handles yours.

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Quotations are from 42 CFR §§405.1200–405.1206 and §§422.624–422.626 (eCFR, current as of 2026-09-24) and Form CMS-10123-NOMNC. We state what the rules say, not what they mean for your case. Content reviewed September 2026. Informational only — not medical, legal, or billing advice. The appeal phone number on your own notice always governs.