Inpatient Facility Coding & Compliance Alert

Question: My provider renders service in a small, 75 bed Medicare Dependent Rural Hospital (MDH). What are the reimbursement provisions?

Illinois Subscriber

Answer: Such facilities get additional payments based on the status of the hospital. The MDH hospital usually is the one with fewer than 100 beds, located in a rural area, and not otherwise classified as sole community hospitals (SCH). These MDH are paid on the DRG basis or on their costs for specific time periods, whichever is higher. It is paid 75 percent of the difference of the IPPS rate and the hospital specific rate, when that rate is higher than the IPPS rate for that DRG payment amount.