CMS outlines geographic classification appeals process
Compliance Monitor, January 7, 2004
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CMS outlined steps that certain qualifying hospitals can follow to change their geographical classifications, thereby potentially entering a higher-paying geographic area in Medicare's inpatient prospective payment system (IPPS). The agency released the guidance on December 31, 2003.
Hospitals wishing to appeal their geographical classification must do so by February 15, 2004. Reclassifications CMS approves will take effect for the three-year period starting April 1, 2004.
Medicare bases payments for inpatient services on geographical location, among other factors. Urban facilities typically receive payments at a higher rate, and Medicare makes classifications of "urban" or "rural" based on information from the Census Bureau's Metropolitan Statistical Areas. Medicare currently uses classification information based on data from 1990.
For more information or to view CMS's statement, click here.
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