This article is for outpatient prospective payment system (OPPS) providers that have multiple service locations submitting claims to A/B Medicare administrative contractors (MACs). This article was revised June 28, 2019, to provide an update on Round 3 testing and to announce a delay of full implementation until October 2019. [SE 19007]
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.
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.
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.
