Introduction: CMS Reimbursement and Essential CMS-1500 Instructions

profileMs.Bubbles

 

The Prospective Payment System of CMS consists of thirteen schedules that allow the calculation of payment for a patient encounter. The DRG or price-based system covers inpatient charges from one of these schedules.

Tasks:

  • Describe the schedules of CMS.
  • Provide an example of a charge for each schedule.
  • Describe the case mix concept that alters payment rates.
  • Describe the diagnosis related group payment system.
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