This page has general description about a prospective payment systems pps see the related links for more specific information about pps for acute inpatient hospitals skilled nursing facilities hospital outpatient home health agencies long term care hospitals inpatient rehabilitation facilities and inpatient psychiatric facilities. A prospective payment system is a system where the insurance company bases the amount that they pay on a pre determined set of costs depending on the classification of the service provided this is a system associated most frequently with medicare. Prospective payment system a healthcare payment system used by the federal government since 1983 for reimbursing healthcare providers agencies for medical care provided to medicare and medicaid participants the payment is fixed and based on the operating costs of the patients diagnosis. Prospective payment systems pps defined a prospective payment system pps is a method of determining reimbursement to health care providers based on predetermined factors not on individual services there are a number of insurance companies and government programs that have adopted pps reimbursement methods. A prospective payment system pps is a term used to refer to several payment methodologies for which means of determining insurance reimbursement is based on a predetermined payment regardless of the intensity of the actual service provided it includes a system for paying hospitals based on predetermined prices from medicare
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