PPS (Prospective payment system)
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.
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]
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]
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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