This article is for outpatient prospective payment system (OPPS) providers that have multiple service locations submitting claims to A/B MACs. This article was revised March 24, 2020, to announce a delay until further notice to the activation of systematic validation edits for OPPS providers with multiple service locations. [SE 19007]
This Interactive Cost Outlier Tool is provided to assist you in determining the proper billing of your inpatient prospective payment (IPPS) outlier claims.
An overview of the PPS for hospital outpatient services, some Part B services furnished to hospital inpatients who have no Part A coverage, and hospitalization services furnished by community mental health centers.
An overview for both the operating and capital-related costs of hospital inpatient stays in long-term care hospitals (LTCHs) under Medicare Part A based on prospectively set rates.
The Social Security Act set a system of payment for the operating costs of acute care hospital inpatient stays under Medicare Part A (hospital insurance) based on prospectively set rates.
Here is an overview of the payment process for an inpatient psychiatric facility, also referred to as a TEFRA (Tax Equity and Fiscal Responsibility Act) facility.
First Coast Service Options (First Coast) strives to ensure that the information available on our provider website is accurate, detailed, and current. Therefore, this is a dynamic site and its content changes daily. It is best to access the site to ensure you have the most current information rather than printing articles or forms that may become obsolete without notice.
