Prospective payment system

Prospective payment system

A method of reimbursement in which Medicare payment is made based on a predetermined, fixed amount. The payment amount for a particular service is derived based on the classification system of that service (for example, DRGs for inpatient hospital services).

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Part of Speech: noun
Synonym(s):
Blossary:
Industry/Domain: Insurance
Category: Medicare & Medicaid
Company: Centers for Medicare & Medicaid Services
Product:
Acronym-Abbreviation:

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Related terms

prospective payment system (PPS)

Health care; General

A payment method that establishes rates, prices or budgets before services are rendered and costs are incurred. Providers retain or absorb at least a portion of the difference ...

prospective payment system

Insurance; Medicare & Medicaid

A method of reimbursement in which Medicare payment is made based on a predetermined, fixed amount. The payment amount for a particular service is derived based on the ...

outpatient prospective payment system

Insurance; Medicare & Medicaid

The way that Medicare pays for most outpatient services at hospitals or community mental health centers under Medicare Part B.

prospective payment system

Medical; Health care; Medicine

A system wherein reimbursement rates are set, for a given period of time, prior to the circumstances giving rise to actual reimbursement claims.

inpatient prospective payment system (IPPS)

Health care; General

Medicare's payment system for inpatient hospitals and facilities. The specific amount that is paid is based on the DRG for the hospital admission.

outpatient prospective payment system (OPPS)

Health care; General

Medicare's system for payment to outpatient departments of hospitals and other outpatient facilities. The specific amount that is paid is determined by the relevant APC.