PPS (Prospective payment system)
Change request (CR) 10547 provides information and implementation instructions for Sections 50204, 50205, and 51005 of the Advancing Chronic Care, Extenders, and Social Services (ACCESS) Act of 2018, which addresses certain provisions that were expired October 2017. [MM10547]
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.
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.
Change request 10515 describes changes to the outpatient prospective payment system (OPPS) to be implemented in the April 2018 update. In addition, these changes will be reflected in the April 2018 integrated outpatient code editor. This article was revised March 22 to reflect a change request (CR) that updated the number of drugs and biologicals with OPPS pass-through status effective April 1, 2018, from twelve to eleven and to remove HCPCS code J0606 from Table 5, Attachment A in the CR since its status indicator remains "K" for the April update. [MM10515]
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.
An overview of the PPS for inpatient rehabilitation hospitals and rehabilitation units -- referred to as inpatient rehabilitation facilities (IRFs).
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.
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