What Is Medicare PPS?

According to the Centers for Medicare & Medicaid Services website, Medicare PPS stands for Prospective Payment Systems. This is a system of Medicare reimbursing hospitals and treatment facilities for services based on a predetermined amount per service.
  1. Uses

    • The Medicare PPS is used by the Centers for Medicare & Medicaid Services to pay for particular services. The institutions that use the PPS include acute inpatient hospitals, home health agencies, and hospices.

    Amount

    • The American Speech-Language-Hearing Association reports the Medicare PPS provides a single payment for the treatment of a person covered by Medicare. This differs from the traditional system of monthly premiums paid to a facility by a Health Management Organization (HMO).

    Classification

    • The CMS (Centers for Medicare & Medicaid Services) explains the PPS classifies treatments and care by cost prior to being needed by a patient. By holding the payment to a set amount, Medicare attempts to ensure treatments are focused on the condition being treated.

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