PPS (Prospective payment system)
Change request 10515 describes changes to the outpatient prospective payment system to be implemented in the April 2018 update. In addition, these changes will be reflected in the April 2018 integrated outpatient code editor. [MM10515]
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 March 2 to reflect the revised CR 10474 issued March 1. In the article, the CR release date, transmittal number and the web address for accessing the CR are revised. All other information remains the same. [MM10474]
An overview of the PPS for inpatient rehabilitation hospitals and rehabilitation units -- referred to as inpatient rehabilitation facilities (IRFs).
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.
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.
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