Federal (United States) · Agency guidance
Chapter 3
281 sections
281 sections
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 6Blend Year 1 (represents 50% site
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 7Blend Years 2 through 4 (represents
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 8Blank – Transition Blend no longer
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 10General Inpatient Requirements
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 10.1Claim Formats
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 10.2Focused Medical Review (FMR)
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 10.3Spell of Illness
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 10.4Payment of Nonphysician Services for Inpatients
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 10.5Hospital Inpatient Bundling
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 20Payment Under Prospective Payment System (PPS) Diagnosis Related
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 20.1Hospital Operating Payments Under PPS
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 20.1.1Hospital Wage Index
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 20.1.2Outliers
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 20.1.2.1Cost to Charge Ratios
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 20.1.2.2Statewide Average Cost-to-Charge Ratios
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 20.1.2.3Threshold and Marginal Cost
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 20.1.2.4Transfers
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 20.1.2.5Reconciliation
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 20.1.2.6Time Value of Money
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 20.1.2.7Procedure for Medicare Contractors to Perform and Record
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 20.1.2.8Special Outlier Payments for Burn Cases
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 20.1.2.9Medical Review and Adjustments
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 20.1.2.10Return Codes for Pricer
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 20.2Computer Programs Used to Support Prospective Payment System
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 20.2.1Medicare Code Editor (MCE)
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 20.2.1.1Paying Claims Outside of the MCE
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 20.2.1.1.1Requesting to Pay Claims Without MCE Approval
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 20.2.1.1.2Procedures for Paying Claims Without Passing through the
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 20.2.2DRG GROUPER Program
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 20.2.3PPS Pricer Program
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 20.2.3.1Provider-Specific File
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 20.3Additional Payment Amounts for Hospitals with Disproportionate
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 20.3.1Clarification of Allowable Medicaid Days in the Medicare
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 20.3.1.1Clarification for Cost Reporting Periods Beginning On or After
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 20.3.1.2Hold Harmless for Cost Reporting Periods Beginning Before
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 20.3.1.3Disproportionate Share Hospital (DSH) Policy Changes Effective
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 20.3.1.4Disproportionate Share Hospital (DSH) Policy Changes Effective
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 20.3.2Updates to the Federal Fiscal Year (FY) 2001
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 20.3.2.1Inpatient Hospital Payments and Disproportionate Share
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 20.3.3Prospective Payment Changes for Fiscal Year (FY) 2003
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 20.3.4Prospective Payment Changes for Fiscal Year (FY) 2004 and
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 20.4Hospital Capital Payments Under PPS
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 20.4.1Federal Rate
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 20.4.2Hold Harmless Payments
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 20.4.3Blended Payments
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 20.4.4Capital Payments in Puerto Rico
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 20.4.5Old and New Capital
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 20.4.6New Hospitals
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 20.4.7Capital PPS Exception Payments
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 20.4.8Capital Outliers
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 20.4.9Admission Prior to and Discharge After Capital PPS
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 20.4.10Market Basket Update
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 20.5Rural Referral Centers (RRCs)
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 20.6Criteria and Payment for Sole Community Hospitals and for
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 20.7Billing Applicable to PPS
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 20.7.1Stays Prior to and Discharge After IPPS Implementation Date
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 20.7.2Split Bills
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 20.7.3Payment for Blood Clotting Factor Administered to Hemophilia
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 20.7.4Cost Outlier Bills With Benefits Exhausted
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 20.8Payment to Hospitals and Units Excluded from IPPS for Direct
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 30Medicare Rural Hospital Flexibility Program and Critical Access
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 30.1Requirements for CAH Services, CAH Skilled Nursing Care Services
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 30.1.1Payment for Inpatient Services Furnished by a CAH
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 30.1.1.1Payment for Inpatient Services Furnished by an Indian Health
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 30.1.2Payment for Post-Hospital SNF Care Furnished by a CAH
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 30.1.3Costs of Emergency Room On-Call Providers
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 30.1.4Costs of Ambulance Services
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 40Billing Coverage and Utilization Rules for PPS and Non-PPS Hospitals
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 40.1"Day Count" Rules for All Providers
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 40.2Determining Covered/Noncovered Days and Charges
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 40.2.1Noncovered Admission Followed by Covered Level of Care
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 40.2.2Charges to Beneficiaries for Part A Services
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 40.2.3Determining Covered and Noncovered Charges - Pricer and PS&R
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 40.2.4IPPS Transfers Between Hospitals
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 40.2.5Repeat Admissions
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 40.2.6Leave of Absence
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 40.3Outpatient Services Treated as Inpatient Services
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 40.3.1Billing Procedures to Avoid Duplicate Payments
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 50Adjustment Bills
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 50.1Tolerance Guidelines for Submitting Adjustment Requests
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 50.2Claim Change Reasons
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 50.3Late Charges
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 60Swing-Bed Services
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 70All-Inclusive Rate Providers
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 70.1Providers Using All-Inclusive Rates for Inpatient Part A Charges
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 80Hospitals That Do Not Charge
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 80.1Medicare Summary Notice (MSN) for Services in Hospitals That Do
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 90Billing Transplant Services
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 90.1Kidney Transplant - General
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 90.1.1The Standard Kidney Acquisition Charge
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 90.1.2Billing for Kidney Transplant and Acquisition Services
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 90.1.3Billing for Donor Post-Kidney Transplant Complication Services
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 90.2Heart Transplants
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 90.3Stem Cell Transplantation
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 90.3.1Allogeneic for Stem Cell Transplantation
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 90.3.2Autologous Stem Cell Transplantation (AuSCT)
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 90.4Liver Transplants
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 90.4.1Standard Liver Acquisition Charge
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 90.4.2Billing for Liver Transplant and Acquisition Services
- Medicare Claims Processing Manual (Pub. 100-04), Ch. 3 § 90.5Pancreas Transplants Kidney Transplants