Test Your OASIS Savvy ... True or False? Under the prospec-tive payment system, patients who have a similar number of visits have a similar effect on your agency's finances. Answer: False. Unlike previous payment systems, PPS is not a visit-based system. Even when visits per episode are similar, profits can vary widely by diagnosis, reports Seattle-based Outcome Concept Systems.
For example, according to OCS' data, in fiscal year 2003, patients with congestive heart failure (ICD-9-CM code 428) received an average of 17 visits, while patients with abnormality of gait (781) averaged 18 visits. But net revenue per episode was $1,250 higher for abnormality of gait than for CHF, OCS reports.