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Medicare & Medicaid

Medicare & Medicaid

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outpatient

What does outpatient mean?

healthinsurance.org health insurance glossary

What does outpatient mean?

An individual (patient) who receives healthcare services (such as surgery) on an outpatient basis, meaning they are not admitted to a hospital or other inpatient facility. Outpatient care can be provided in a variety of settings, including a doctor’s office, clinic, urgent care facility, surgery center, or a hospital.

In most cases, staying overnight in the hospital means that you’re being treated as an inpatient rather than on an outpatient basis. However, Medicare patients sometimes receive “observation” services in the hospital, and are classified as outpatients despite staying overnight in the hospital.1 This can affect your costs, since Medicare Part A (inpatient) and Medicare Part B (outpatient, including observation) have different out-of-pocket costs.

The term outpatient is also used synonymously with ambulatory to describe health care facilities where outpatient procedures are performed. So an outpatient surgery center means the same thing as an ambulatory surgery center.

Footnotes

  1. FFS & MA MOON” CMS.gov. Oct. 15, 2024 
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