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IPPS Outlier Reconciliation

This transmittal tells FIs how to implement the policies of IPPS reconciliation and how to apply the time value of money to reconciliation. It also
tells how to calculate cost-to-charge ratios and when to use alternative data for cost-tocharge ratios. Finally, it tells FIs which cost-to-charge ratio to apply in instances of hospital mergers and what to do when errors occur with cost-to-charge ratios and outlier payments.

Download the Guidance Document

Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: October 12, 2005

DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.