Understanding Medicare PPS: A Comprehensive Guide

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.

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.