Which payment classification system is used for billing hospital-based Medicare outpatient claims?

The Outpatient Prospective Payment System (OPPS) is specifically designed for Medicare billing of outpatient services provided by hospitals. It categorizes various outpatient services into different Ambulatory Payment Classifications (APCs), with each classification having a predetermined payment rate. This system streamlines billing and reimbursement for outpatient hospital care, ensuring that hospitals receive consistent and predictable payments for the services rendered to Medicare beneficiaries.

The importance of OPPS lies in its focus on outpatient care, which encompasses a wide range of services such as emergency room visits, outpatient surgeries, and diagnostic tests. By utilizing this system, Medicare can effectively manage costs and encourage hospitals to provide efficient care while maintaining quality standards.

In contrast, the other options refer to payment systems designated for different healthcare settings and services. For example, the Home Health Prospective Payment System addresses reimbursement for home health services, while both the Inpatient Psychiatric Facility Prospective Payment System and the Skilled Nursing Facility Prospective Payment System focus on inpatient psychiatric and skilled nursing facility care, respectively. None of these systems pertains to outpatient hospital claims, making the Outpatient Prospective Payment System the appropriate choice.