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Site-Neutral IPPS Payment Amount

CLM_SITE_NTRL_IP_PPS_PYMT_AMT

Section 1206(a) of Public Law 113-67 amended Section 1886(m) of the Act to establish patient-level criteria for payments under the LTCH PPS (Long Term Care Hospital Prospective Payment System) for implementation beginning for cost reporting periods beginning on or after October 1, 2015. The site-neutral Inpatient Prospective Payment System (IPPS) amount will be paid for patients discharged from the LTCH that do not meet criteria to be paid at the standard LTCH PPS amount.

Field Metadata

FHIR Resource
ExplanationOfBenefit
FHIRPath
ExplanationOfBenefit.adjudication.where(
  category.coding.where(
    system = 'https://bluebutton.cms.gov/fhir/CodeSystem/Adjudication'
  ) and
    category.coding.where(
      code = 'CLM_SITE_NTRL_IP_PPS_PYMT_AMT'
    )
).amount.value
Coverage / Claim Type
  • Inpatient
Source View
V2_MDCR_CLM_INSTNL
Source Column
CLM_SITE_NTRL_IP_PPS_PYMT_AMT
Sources
  • FISS
  • NCH
Profiles
  • CMS

Example

10.1

bluebutton.cms.gov

official website of theU.S. Department of Health and Human Services and theCenters for Medicare & Medicaid Services.

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