Medicare reimbursement methods are highly complex and constantly changing.  Here are a series of concise briefings on Medicare payment policy for healthcare providers, Medicare Advantage plans, and Medicare Part D drug plans.

These primers on Medicare payment basics are courtesy of the outstanding staff at the Medicare Payment Advisory Commission (MedPAC).  MedPAC updates these briefs on Medicare payment basics every year based on changes made in legislation or in rules from the Centers for Medicare and Medicaid Services (CMS).

Medicare Payment for Inpatient Hospital Services:

• Hospital acute inpatient services payment system (inpatient prospective payment system)
• Critical access hospitals payment system
• Psychiatric hospital services payment system

Medicare Payment for Post-Acute Providers:

• Home health care services payment system
• Skilled nursing facility services payment system
• Inpatient rehabilitation facilities payment system
• Long-term care hospitals payment system

Medicare Payment for Physician and Other Outpatient Services:

• Physician and other health professionals payment system
• Outpatient hospital services payment system (outpatient prospective payment system)
• Ambulatory surgical center services payment system
• Outpatient dialysis services payment system (Medicare ESRD)
• Durable medical equipment payment system
• Clinical laboratory services payment system
• Oxygen and oxygen equipment payment system
• Outpatient therapy services payment system
• Hospice services payment system

Medicare Health Plans and Meedicare Drug Plans:

• Medicare Advantage program payment system (Medicare HMOs, PPOS, and Special Needs Plans)
• Part D drug benefit payment system for Medicare Prescription Drug Plans (PDPs) and Medicare Advantage Drug plans (MAPDs)