Reimbursement and Coding

Medicare Reimbursement Guides

• Inpatient Prospective Payment System (IPPS)

  This guide provides a summary of the Medicare Hospital Inpatient Prospective Payment System (IPPS). It includes information on the Readmission Reductions Program, Value Based Purchasing, and Hospital Inpatient Reimbursement Rates for select cardiovascular DRGs. For more detailed information, please refer to the FY IPPS Final Rule on the CMS website.

• Outpatient Prospective Payment System (OPPS)

  This guide provides a summary of the Medicare Hospital Outpatient Prospective Payment System (OPPS) Update. It includes updates to the Comprehensive APC Policy, Site Neutral Payments, Device Intensive Procedures, the Transitional Pass-Through Payment Policy, and Hospital Outpatient Reimbursement Rates for select cardiovascular APCs. For more detailed information, please refer to the CY OPPS Final Rule on the CMS website.

• Ambulatory Surgical Center and Office Based Lab Reimbursement Guide

  Medicare coding and payment guide for procedures performed in ASC and OBL settings

• Physician Fee Reimbursement Guide

  This guide includes Medicare Physician Payment Rates for cardiovascular procedures. For more detailed information, please refer to the CY Physician Fee Schedule Final Rule on the CMS website.

• HCPCS Device Category C-Codes

  Current list of reimbursement Healthcare Procedural Coding System (HCPCS) Device Category C-codes