US · guidance
CMS Pub. 100-04, ch. 4, § 140
All-Inclusive Rate Hospitals
A-01-93, A-03-066
All-inclusive rate hospitals are required to code with HCPCS the outpatient services they
provide and bill charges at the HCPCS level. In addition, they are required to follow bill
reporting instructions contained in §30. Unlike other hospitals, all-inclusive rate
hospitals do not have outpatient departmental cost-to-charge ratios from prior year cost
reports that may be used for calculating outlier payments, device pass-through payments,
or interim transitional corridor payments. As a result, A/B MACs (A) use the statewide
average urban or rural outpatient cost-to-charge ratio, as appropriate, for all-inclusive rate
hospitals. In the future, once cost and charge data for an all-inclusive rate hospital is
available, the A/B MAC (A) will be able to apply a cost-to-charge ratio that is specific to
the hospital.
History
(Rev. 1, 10-03-03)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
9a0ba96abe68281fee7ec05c874e7514ca0644b10112b63f12dde516339c1801
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