Skip to main content
It looks like you're using Internet Explorer 11 or older. This website works best with modern browsers such as the latest versions of Chrome, Firefox, Safari, and Edge. If you continue with this browser, you may see unexpected results.
42 US Code 1395ww
The inpatient hospital prospective payment system (IPPS) applies to all short-term hospital stays unless they are specifically excluded from the IPPS.
42 US Code 1395l
Payment of benefits for Medicare Part B.
42 CFR 412.154
The Hospital Readmissions Reduction Program (HRRP) reimbursements from Medicare for to hospitals that have excess readmissions for certain medical conditions, such as pneumonia and heart failure. It is meant to improve quality of health care.
42 CFR 412.152
Definitions for the Hospital Readmissions Reduction Program.
42 CFR 412.172
The Hospital-Acquired Condition (HAC) Reduction Program reduces reimbursements by 1% to hospitals that rank in the worst performing quartile of hospitals with respect to risk-adjusted HAC quality measures.
79 Fed. Register 49854, Aug. 22, 2014, Final Rule
Hospital-Acquired Conditions Present on Admission Indicator Program - If select conditions, such as air embolism and catheter-associated urinary tract infections, manifest during the hospital stay, the case is paid as though the secondary diagnosis was not present.
42 CFR 419.2
Outpatient services are covered under Medicare Part B and paid under the outpatient prospective payment system (OPPS).
42 CFR 416.166
CMS pays for outpatient surgeries using a payment system based on OPPS.