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March 4, 2023

Introduction: The Prospective Payment System of CMS consists of thirteen schedules that allow the calculation of payment for a patient encounter. The DRG or price-based sy

Introduction:

The Prospective Payment System of CMS consists of thirteen schedules that allow the calculation of payment for a patient encounter. The DRG or price-based system covers inpatient charges from one of these schedules.

Tasks:

Describe the schedules of CMS.
Provide an example of a charge for each schedule.
Describe the case mix concept that alters payment rates.
Describe the diagnosis related group payment system.

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