Updated August 7, 2026. Quick answer: a Notice of Medicare Non-Coverage (Form CMS-10123) says your Medicare-covered services — skilled nursing, home health, hospice or rehab — are ending on a stated date. 🔴 You can ask for a fast review, and the deadline is brutally short: by noon of the calendar day after you get the notice. Missing that deadline does not end your appeal, but it does cost you the part that protects your wallet.
What this notice is
The NOMNC is delivered by the provider — the nursing facility, home health agency, hospice or rehab clinic — not by Medicare. CMS describes its job plainly: it “informs beneficiaries of their discharge when their Medicare covered services are ending.”
It is not a statement that you are well. It is a statement that the provider has decided Medicare will no longer pay, which is a different question and is the one you can contest.
When it must reach you
The regulation sets the delivery rule:
A provider must notify the beneficiary of the decision to terminate covered services no later than 2 days before the proposed end of the services.
If the services were expected to last fewer than two days, the notice comes at admission instead. And there is a consequence for getting delivery wrong: the provider is financially liable for continued services until 2 days after you receive valid notice, or until the termination date on the notice, whichever is later.
⚠️ If you refuse to sign it, the date of your refusal counts as the date you received it. Refusing to sign does not buy time.
🔴 The noon rule
This is the number that decides everything, and it is in the regulation in these words:
A beneficiary who wishes to exercise the right to an expedited determination must submit a request… to the QIO in the State in which the beneficiary is receiving those provider services, in writing or by telephone, by no later than noon of the calendar day following receipt of the provider’s notice of termination.
If the QIO cannot accept the request that day, you have until noon of the next day the QIO is available. The request goes to the Quality Improvement Organization for your state — the notice itself must carry that phone number.
A telephone call counts. You do not need a lawyer, a form, or a written argument to start this.
🔴 What being late actually costs
This is the part almost nobody explains, and it is the reason the deadline matters so much more than it looks:
If a beneficiary makes an untimely request for an expedited determination by a QIO, the QIO will accept the request and make a determination as soon as possible, but the 72-hour time frame… and the financial liability protection… do not apply.
So missing noon does not destroy your appeal. It destroys the protection. A timely request buys a decision on a 72-hour clock and shields you from the cost of the days under review. A late one gets you a decision eventually, with the bill running in the meantime.
What happens to your care while you wait
Coverage “continues until the date and time designated on the termination notice, unless the QIO reverses the provider’s service termination decision.” You are not thrown out the moment you appeal, and you are not automatically covered past the notice date either.
If you ask for the fast review, you should also receive a Detailed Explanation of Non-Coverage (Form CMS-10124) — CMS says it is “given only if a beneficiary requests an expedited determination.” That document is where the provider has to say why, which is what you actually need in order to argue.
Two situations the rule is written for
The expedited route exists where a physician certifies that stopping the services “may place the beneficiary’s health at significant risk”, and — for a residential provider or a hospice — where the beneficiary simply disagrees with the decision to discharge. The second is a lower bar than most families assume.
How the stay got here
A NOMNC usually arrives partway through a benefit most people misunderstand from the start. Medicare pays in full for 20 skilled-nursing days and charges a daily coinsurance for days 21 to 100 — what the 100 days actually cover. And the stay only qualified at all if the hospital days before it were inpatient days: observation is not inpatient, and the difference decides whether Medicare pays for any of this.
Sources
Honest note on sourcing. The rules above are quoted from the Code of Federal Regulations via eCFR, retrieved 7 August 2026: 42 CFR § 405.1200 (delivery, timing and provider liability) and 42 CFR § 405.1202 (the expedited determination, the noon deadline, and the untimely-request consequence). The form names and numbers are from CMS’s own Beneficiary Notices Initiative page. We are not printing a QIO phone number — it is state-specific and it is printed on your notice.
Related: the Medicare notices index.