Question

Which type of hospitals are excluded from Medicare PPS and still paid on the basis of reasonable cost, subject to payment limits per discharge or under a separate PPS?

1) Critical Access Hospitals
2) Long-Term Care Hospitals
3) Inpatient Rehabilitation Facilities
4) Psychiatric Hospitals

Answer 1

Critical Access Hospitals are the type of hospitals exempted from Medicare PPS and instead are reimbursed based on the reasonable cost of the services they provide.

Step-by-step explanation:

The type of hospitals that are excluded from Medicare Prospective Payment System (PPS) and are still paid on the basis of reasonable cost, subject to payment limits per discharge or under a separate PPS are Critical Access Hospitals (CAHs). These hospitals are designated to provide care to rural communities, and they receive this special status because they fulfill certain criteria, such as being located a certain distance from other hospitals and having a limited number of beds. They are thus reimbursed based on the cost of services they provide, rather than under the PPS that most hospitals are subject to. Long-Term Care Hospitals, Inpatient Rehabilitation Facilities, and Psychiatric Hospitals, while also having different payment arrangements under Medicare, do not fit the description of being paid strictly on the basis of reasonable cost like the Critical Access Hospitals.