A Prospective Payment System (PPS) is a method of reimbursement in which Medicare payment is made based on a predetermined, fixed amount. The payment amount for a particular service is derived based on the classification system of that service (for example, DRGs for inpatient hospital services).  CMS uses separate PPSs for reimbursement to acute inpatient hospitals, home health agencies, hospice, hospital outpatient, inpatient psychiatric facilities, inpatient rehabilitation facilities, long-term care hospitals, and skilled nursing facilities.  See Related Links below for information about each specific PPS.

ZIPCODE TO CARRIER LOCALITY FILE (see file below)
This file is primarily intended to map ZIP Codes to CMS carriers and localities. This file will also map Zip Codes to their State. In addition, this file contains an urban, rural or a low density (qualified) area Zip Code indicator.

PROVIDER CENTER
For a one-stop resource web page focused on the informational needs and interests of Medicare Fee-for-Service (FFS) providers, including physicians, other practitioners and suppliers, go to the Provider Center (see under "Related Links Inside CMS" below).

Downloads
Zip Code to Carrier Locality File [ZIP 4.3MB] - Updated 11/13/08 Zip Codes requiring +4 extension [ZIP, 2KB] - Updated 11/13/08 Zip 5 Changes for July 08 [PDF, 9KB]
Related Links Inside CMS
Acute Inpatient PPS Home Health PPS Hospice Inpatient Psychiatric Facilities PPS Inpatient Rehabilitation Facilities PPS Long-Term Care Hospital PPS Skilled Nursing Facilities PPS Provider Center Inpatient PPS PC Pricer
Related Links Outside CMS
There are no Related Links Outside CMS

Page Last Modified: 11/13/2008 8:14:22 AM
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