National Medicare Provider Rate File (NMPRF) Overview

PPS Strategies

NMPRF contains the payment rates that payers need to develop fair and defensible reimbursement rates when applying PPS to commercial business, or for creating payment strategies for Medicare Advantage and Medicaid programs.

Highlights

• Analyze PPS rates on a regional or nationwide basis
• Rely on accurate data in contract negotiations
• Five state-specific rate files available

Detailed Information

NMPRF contains the information needed to calculate inpatient acute hospital reimbursement (including inlier, outlier, and transfer payments) according to the rules of the Medicare PPS system for operating and capital-related costs.