skip to content
Thank you for visiting First Coast Service Options' Medicare provider website. This website is intended exclusively for Medicare providers and health care industry professionals to find the latest Medicare news and information affecting the provider community.
To enable us to present you with customized content that focuses on your area of interest, please select your preferences below:
Select which best describes you:
Select your location:
Select your line of business:
This website provides information and news about the Medicare program for health care professionals only. All communication and issues regarding your Medicare benefits are handled directly by Medicare and not through this website. Information for Medicare beneficiaries is only available on the website.
En Español
Text Size:
Send a link to this page
[Multiple email adresses must be separated by a semicolon.]

PPS (Prospective payment system)

Modified: 6/7/2018
Change request 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. [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: 5/29/2018
Change request (CR) 10474 terminates diagnosis code D68.32, effective July 1. Providers that include diagnosis code D68.32 on inpatient claims with discharge dates after July 1, 2018, will not receive the add-on payment. This article was revised May 25 to correct the code description for ICD-10-CM D68.32. In the article, the code description is corrected and the CR release date, transmittal number, and the web address for accessing the CR are revised. [MM10474]
Modified: 5/15/2018
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]
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.
Modified: 1/25/2018
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