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PPS (Prospective payment system)

Modified: 12/29/2017
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: 12/28/2017
Modified: 11/27/2017
Change request 10377 adds logic into the skilled nursing facility (SNF) prospective payment system (PPS) pricer to apply the quality reporting program (QRP) payment reduction for fiscal year 2018, which applies to those facilities that do submit require quality data. [MM10377]
Modified: 11/14/2017
Change request (CR) 10175 provides instructions for payment to rural health clinics (RHCs) billing under the all-inclusive rate, and federally qualified health centers (FQHCs) billing under the prospective payment system, for care coordination services for dates of service on or after January 1, 2018. This article was revised November 13 to correct statements on page 2 (in bold). All other information is unchanged. [MM10175]
Modified: 11/11/2017
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: 9/29/2017
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: 9/29/2017
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.
Modified: 8/2/2017
An overview of the PPS for inpatient rehabilitation hospitals and rehabilitation units -- referred to as inpatient rehabilitation facilities (IRFs).
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.
Part A