PPS (Prospective payment system)
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]
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.
Diagnosis code update for add-on payments for blood clotting factor administered to hemophilia inpatients
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]
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.
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).
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