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PPS (Prospective payment system)

Modified: 7/26/2018
An overview of the PPS for inpatient rehabilitation hospitals and rehabilitation units -- referred to as inpatient rehabilitation facilities (IRFs).
Modified: 7/11/2018
The Centers for Medicare & Medicaid Services (CMS) recently released information on the fiscal year 2019 Medicare Part A skilled nursing facility prospective payment system pricer update. The payment rates will be effective October 1, 2018. [MM10825]
Modified: 6/20/2018
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. This article was revised June 19 to add information on the revenue codes to be used for reporting code Q5105 on the 72x type of bill for ESRD beneficiaries. All other information remains the same. [MM10818]
Modified: 6/20/2018
Change request (CR) 10781 describes changes to the outpatient prospective payment system (OPPS) to be implemented in the July 2018 update. In addition, these changes will be reflected in the July 2018 integrated outpatient code editor. This article was revised June 19 to reflect an updated CR, which adds new codes Q5105-Q5106, 0045U-0061U, and Q9994. Also, the status indicator for J9216 and Q2049 changes effective July 1. The CR release date, transmittal number, and link to the transmittal also changed. [MM10781]
Modified: 5/30/2018
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: 5/4/2018
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: 4/4/2018
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: 3/15/2018
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.