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April 2, 2021

The IPF PPS is based on a federal perdiem amount that represents the average daily operational, ancillary, and capital costs expended to care for Medicare beneficiaries.  Use the information found in figures 1 and 2 ( below), Tables 6.5-6.9 and figures 6.7 from the test book to complete table 1 and workbooks A&B in order to determine IPF PPS reimbursement for this encounter.

Figure 1: Facility Information

Bed size: 350 beds

Location: Columbus, Ohio

Classification: Rural

Wage Index: .9806

Full Service ED: Yes

Per-diem unadjusted rate (RY 2015): $728.31

 

 

Figure 2: Claim Information

Admit Date: January 1, 2015

Discharge Date: January 15, 2015

LOS: 14 days

Patient Age: 62

 

Principal Diagnosis: 295.34*

Paraphrenic schizophrenia, chronic with acute exacerbation

Secondary Diagnosis: 301.6

Dependent personality disorder

Secondary Diagnosis: 250.02

Type II diabetes mellitus uncontrolled

MS-DRG: 885

Psychoses

ECT treatments: 90870

3 units

$315.55 per unit (RY 2015)

 
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