CMS Reimbursement and Essential CMS-1500 Instructions
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.
- 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.