Outlier Reconciliation and CCR Updates for the IPPS and LTCH PPS - Rescinded

Related CR Release Date: April 26, 2024
Effective Date: October 1, 2024
Implementation Date: October 1, 2024
Related Change Request (CR) Number: CR 13566
Related CR Transmittal Number: R12594CP

Note: Transmittal 12558 issued March 28, 2024, is being rescinded and replaced by Transmittal 12594, dated April 26, 2024, to update example B in Publication 100-04, Chapter 3, Section - Reconciliation.

CR 13566 adds new criteria for determining which hospitals shall have their outlier payments reconciled under the Inpatient Prospective Payment System (IPPS) and Long-Term Care Hospital (LTCH) PPS. CMS is also cross walking the calculation of the IPPS operating and capital Cost-to-Charge Ratio (CCR) and the LTCH CCR from Form CMS-2552-1996 cost report to the Form 2552-2010 cost report.

Make sure your billing staff knows about these changes.

View the complete CMS Change Request (CR)13566.

Last Updated Jun 14 , 2024