Two-Midnight Rule

Regla de las Dos Medianoche

In 9 languages

LanguageTerm
EnglishTwo-Midnight Rule
Spanish (Español) Regla de las Dos Medianoche
Chinese (中文) 两夜规则
Korean (한국어) 2자정 규칙
Vietnamese (Tiếng Việt) Quy tắc Hai Nửa đêm
Filipino (Tagalog) Two-Midnight Rule
Portuguese (Português) Regra das Duas Meia-Noites
Thai (ภาษาไทย) กฎสองเที่ยงคืน
Japanese (日本語) 二夜規則

What it means

The two-midnight rule is a Medicare billing policy stating that when a hospital physician expects a patient to need care spanning at least two midnights, the stay is presumed an appropriate inpatient admission billable under Part A. Stays expected to be shorter are generally classified as outpatient observation status, billed under Part B—which may result in higher patient cost-sharing and disqualifies the stay from counting toward the three-day inpatient requirement needed for subsequent skilled nursing facility coverage. Always ask your care team whether you are admitted as inpatient or are under observation status, since the financial implications are significant.

How to say it

Sentences a patient might use with a doctor, nurse, pharmacist, or insurer:

too MID-nyt rool

regla de las dos medianoche

Also called the 'two-midnight presumption'

También llamada 'presunción de dos medianoche'

Ask your doctor: 'Am I admitted as inpatient or under observation?'

'¿Estoy admitido como paciente hospitalizado o bajo observación?'

Where you'll see it

Medicare Summary NoticeNotice of Observation Treatment (IM notice)Hospital billing statementMedicare & You handbook

Related terms

Sources

US Glossary Español A–Z US Codes United States

Last reviewed: September 2026