BRS supports the IPPS payment policies, including:
- Claims priced in accordance with the Inpatient Prospective Payment System (IPPS)
- List of Acute Inpatient Hospitals by facility, searchable by National Provider Identifier (NPI), 6-character CMS Certification Number (CCN) and facility name
- DRG grouping for CMS DRGs (FY 2006 – FY 2007) and MS DRGs (FY 2008 – Present)
- Grouping exceptions for Hospital Acquired Condition using Present On Admission indicators
- Correct Type of Bill logic
- Present on admission valid values
- Pricing with Medicare Advantage exceptions
- Operating and capital costs breakdown
- DSH and IME adjustments
- Outlier add-on for exceptionally costly stays
- MSA or CBSA based wage index adjustment for every hospital accounting for multiple reclassification instructions
- New technology add-ons
- Pass-through per diem payment of Organ Acquisition costs, Direct Graduate Medical Education (DGME), Nursing and Allied Health Professional Education, when applicable
- Separate payment for coagulation drugs for hemophilia patients
- Automatic assessment and special pricing logic for regular transfers or post-acute transfers based on patient discharge status, condition codes and DRG assignment
- Device credit deduction to the IPPS payment based on value code FD and condition codes