Pass Through Per Diem Amount

The maximum amount a provider can be paid for each day of care. [HRMZ] For Medicare IP, the amount of the established reimbursable costs for the current year divided by the estimated Medicare days for the current year (all PPS claims), as calculated by the FI and reimbursement staff. Items reimbursed as a pass through include capital-related costs; direct medical education costs; kidney acquisition costs for hospitals approved as RTCs; and bad debts (per Provider Reimbursement Manual, Part 1, Section 2405.2). Note: Pass through amounts are not included in the claim payment amount. [NCH, HRMZ]

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