A Medicare inpatient is transferred to another acute care hospital. Why might IPPS payment for the transferring hospital differ from a full DRG payment?
Select an answer to reveal the explanation.
Short Explanation
When a patient moves mid-story to another acute hospital, Medicare doesn’t always hand the first hospital the full novel’s royalty. Transfer payment rules can trim or adjust the DRG pay for certain cases. It’s a payment-policy twist, not “bill nothing.”
Full Explanation
IPPS includes transfer-related payment adjustments for specified situations, including certain acute-to-acute transfers and post-acute transfer policies tied to designated DRGs. Payment may be reduced from a full DRG amount based on length of stay and policy rules. Transfers do not erase coding requirements or automatically move the stay to OPPS.