The name given the system currently in use for paying for services for Medicare patients (payment for patients “by Diagnosis Related Groups (DRGs)”). The idea is that patients are classified into categories (in this case, DRGs) for which prices are negotiated or imposed on the hospital in advance; thus it is actually “prospective pricing” rather than “prospective payment.” At present PPS is only applied to hospital care, not physician care, although the idea is the same as a single fixed “package fee” which includes prenatal care, delivery, and postpartum care for a maternity patient, or the inclusion of preoperative care, operation, and postoperative care for an appendectomy patient within one fixed physician’s fee. (In fact, the package fee concept is inherent in Physicians’ Current Procedural Terminology (CPT), published by the American Medical Association (AMA)). PPS, while not mandated by federal law for payers other than Medicare is being applied to patients under other health care plans.<\/p>\n
A reimbursement method used in which a fixed, predetermined amount is allocated for treating patients with a specific diagnosis. It was originally developed for Medicare recipients. It is also called payment-by-diagnosis.<\/p>\n
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The name given the system currently in use for paying for services for Medicare patients (payment for patients “by Diagnosis Related Groups (DRGs)”). The idea is that patients are classified into categories (in this case, DRGs) for which prices are negotiated or imposed on the hospital in advance; thus it is actually “prospective pricing” rather […]<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[16],"tags":[],"class_list":["post-112943","post","type-post","status-publish","format-standard","hentry","category-p"],"yoast_head":"\n