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 …

Level II codes are maintained by the US Centers for Medicare and Medicaid Services (CMS). There is some overlap between HCPCS codes and National Drug Code (NDC) codes, with a …

Berenson-Eggers Type of Service (BETOS) categories are used to analyze Medicare costs. All Health Care Financing Administration Common Procedure Coding System (HCPCS) …

Level III codes, also called local codes, were developed by state Medicaid agencies, Medicare contractors, and private insurers for use in specific programs and jurisdictions. The Health …

Ambulatory Payment Classification APCs or Ambulatory Payment Classifications are the United States government's method of paying for facility outpatient services for the Medicare (United …

Jul 30, 2024 · Medicare usually covers most of your healthcare costs, but if you have other insurance coverage, it can act as a secondary payer for some of the costs.

Jul 2, 2025 · Summary The Inpatient Only (IPO) list is a list of Healthcare Common Procedure Coding System (HCPCS) codes and descriptions that the Centers for Medicare & Medicaid …

Case mix groups are used as the basis for the Health Insurance Prospective Payment System (HIPPS) rate codes used by Medicare in its prospective payment systems. [1] Case mix …