Medicare Inpatient Reimbursement Fundamentals

Medicare Inpatient Reimbursement is the payment system used by the U.S. Medicare program to compensate healthcare providers for the costs associated with providing inpatient hospital services to Medicare beneficiaries.

In this course, you will learn about the Inpatient Prospective Payment System and how it is structured to reimbursement healthcare providers for the items and services furnished to Medicare beneficiaries. This course will also provide you with a general understanding of various payment delivery mechanisms within the IPPS.

Course Outline:

• Section 1: Course Introduction
• Section 2: Medicare Inpatient Prospective Payment System Overview
• Section 3: Medicare IPPS Reimbursement
• Section 4: Medicare IPPS Components Impacting Reimbursement
• Section 5: Medicare IPPS Quality and Value Incentives
• Section 6: Course Assessment

When you complete this course, you’ll be able to: 

• Explore the history and significance of establishing the Medicare Inpatient Prospective Payment System.
• Describe how Medicare reimburses for inpatient care through reimbursement components.
• Examine the impact that hospitals’ geographic location, wage index, value-based purchasing, readmission adjustments, and capital payments have on Medicare reimbursement and to hospital inpatient care.

CPE Information:

CPE Award Amount: 2.0

Program Level: Basic

Program Prerequisite: None

Recommended Experience: Revenue cycle staff, reimbursement professionals, managed care contracting professionals, and financial professionals operate at various levels.

Advanced Preparation: None

Instructional Method: QAS Self-Study

Delivery Method: QAS Self-Study

Field of Study and Topic in hours: Specialized Knowledge – 2.0

CPE Sponsor: Healthcare Financial Management Association is registered with the National Association of State Boards of Accountancy (NASBA)
as a sponsor of continuing professional education on the National Registry of CPE Sponsors. State boards of accountancy have final authority on the acceptance of individual courses for CPE credit. Complaints regarding registered sponsors may be submitted to the National Registry of CPE Sponsors through its website: www.nasbaregistry.org.

For more information regarding refund policies, as well as any program concerns, please contact our offices at 800.252.4362 or, [email protected].

CHCRS Program Enrollment:

The CHCRS designation is earned and awarded upon successful completion of two prerequisite courses, hospital cost report training and CHCRS exam.

Step 1 – Complete the two CHCRS program prerequisite courses. These courses can be taken in any order. A certificate is awarded on completion.

• Prerequisite Course: Medicare Outpatient Reimbursement Fundamentals
  • Cost: Member Included, Non-Member $99
• Prerequisite Course: Medicare Inpatient Reimbursement Fundamentals
  • Cost: Member Included, Non-Member $99

Step 2 – Complete the hospital cost report training. There are two options available.

• Option 1: Complete the HFMA hospital cost report online training course
  • Cost: Member $349, Non-Member – $549.
• Option 2: Complete the FORVIS led virtual cost report training
  • Link: forvis.com/events. Fees apply.
• Step 3 – Successfully complete the CHCRS exam*. When you successfully complete the exam, you will be awarded the CHCRS CPE certificate, digital badge, and designation. Member Included, Non- Member – $200.

* CHCRS Exam Prerequisites: Successful completion of two prerequisite courses and hospital cost report training is required to enroll in the CHCRS exam.

General Program Information