PPS (Prospective payment system)
Modified: 9/15/2017
Change request (CR) 10145 implements a correction to the payment of IPPS transfer claims classified to MS-DRG 385 from full IPPS payment to a per diem transfer payment. In addition, this CR instructs the fiscal intermediary shared system to allow the Part A deductible on Medicare secondary payer same day transfer claims. This article was revised September 13 to reflect a revised CR. That CR removed a business requirement to the Medicare administrative contractors. The CR release date, transmittal number, and link to the transmittal also changed. [MM10145]
Modified: 9/13/2017
Change request (CR) 10273 implements policy changes for fiscal year (FY) 2018 inpatient prospective payment system (IPPS) and long-term care hospital (LTCH) PPS, which unless otherwise noted, are effective for hospital discharges occurring on or after October 1, 2017, through September 30, 2018. [MM10273]
Modified: 8/30/2017
The Centers for Medicare & Medicaid Services (CMS) recently released a list of reimbursement and policy changes for the inpatient rehabilitation facility (IRF) prospective payment system. [MM10125]
Modified: 8/15/2017
The Centers for Medicare & Medicaid Services (CMS) recently released its quarterly update to the end-stage renal disease prospective payment system (ESRD PPS), adding two new procedures to the consolidated billing requirements. [MM10193]
Modified: 8/14/2017
Change request (CR) 9723 implements policy changes for fiscal year (FY) 2017 inpatient prospective payment system (IPPS) and long-term care hospital (LTCH) PPS, which unless otherwise noted, are effective for hospital discharges occurring on or after October 1, 2016, through September 30, 2017. This article was revised August 11 to reflect a revised CR 9723, issued August 9. In the CR, the out migration values in attachment 7 of the CR were revised. In the article, the CR release date, transmittal number, and the web address for accessing the CR are revised. [MM9723]
Modified: 8/9/2017
The Centers for Medicare & Medicaid Services (CMS) released its fiscal year (FY) 2018 update to the inpatient psychiatric facilities prospective payment system (IPF PPS) announcing a new per diem base rate of $771.35 for facilities complying with quality reporting programs. [MM10214]
Modified: 8/2/2017
An overview of the PPS for inpatient rehabilitation hospitals and rehabilitation units -- referred to as inpatient rehabilitation facilities (IRFs).
Modified: 7/14/2017
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.
Modified: 4/15/2017
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.
Modified: 4/7/2017
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.
Modified: 4/7/2017
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.
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