evekhm/cms_iom_500 huggingface dataset:
(Medicare Claims Processing Manual)
90.4 - Type of Bill  (Rev. 2971, Issued: 05- 23-14, Effective: 07 -01-14, Implementation, 07- 07-14)  To properly bill, hospitals other than CAHs assign type of bill (TOB) 13X to all bills for outpatient hospital services and TOB 14X for non -patient (referred) laboratory specimens.  A n on-patient is defined as a beneficiary that is neither an inpatient nor an outpatient of a hospital, but that has a specimen that is submitted for analysis to a hospital and the beneficiary is not physically present at the hospital.  TOB 14X should only be billed for non- patient lab specimens, which are paid under the clinical laboratory fee schedule at the lesser of the actual charge, the fee schedule amount, or the National Limitation Amount (NLA), (including CAHs and MD Waiver hospitals).  Part B deductible and coinsurance do not apply for laboratory tests payable on the laboratory fee schedule.   TOB 14X should no longer be used for referred diagnostic services other than laboratory services.   CAHs should bill TOB 85X for outpatient services (including outpatient labs), and TOB 14X for non- patient laboratory specimen tests.   90.5 - Definition of Diagnostic Services  (Rev. 1, 10- 01-03) HO- 350.E   A service is diagnostic if it is an examination or procedure to which the patient is subjected, or which is performed on materials derived from a hospital outpatient to obtain information to aid in the assessment of a medical condition or the identification of a disease.  Among these examinations and tests are diagnostic laboratory services such as hematology and chemistry, diagnostic x- rays, isotope studies, EKGs, pulmonary function tests, psychological tests, and other tests given to determine the natur e and severity of an ailment or injury.  Hospitals may determine whether services are diagnostic from their internal systems as appropriate.   90.6 - Definition of Encounter  (Rev. 1, 10- 01-03) HO- 350F
(Medicare Claims Processing Manual)
90.6 - Definition of Encounter  (Rev. 1, 10- 01-03) HO- 350F   The term encounter means a direct personal contact in the hospital between a patient and a physician, or other person who is authorized by State law and, if applicable, by hospital staff bylaws to order or furnish services for diagnosis or treatment of the patient.  Direct personal contact does not include telephone contacts between a patient and physician.  Nor is the compensation arrangement between the physician and the hospital relevant to whether an encounter has occurred.  Patients will be treated as hospital outpatients for purposes of billing for certain diagnostic services that are ordered during or as a result of an encounter that occurred while such patients are in  an outpatient status at the hospital.  If a Medicare outpatient is referred to another provider or supplier for further diagnostic testing or other diagnostic services as a result of an encounter that occurs in this hospital, the hospital is responsible f or arranging with the other entity for the furnishing of services.  Hospitals are not required to verify that all ordered services are furnished but only to assure that, when it is necessary to refer a patient to an outside entity, the referral is made to a provider or supplier with which the referring hospital an arrangement.  This requirement is necessary to assure that billing for services that are furnished is processed through the servicing hospital.  When a patient has follow -up visits with a physician in the hospital following an initial encounter, each subsequent visit to the physician will be treated as a separate encounter for billing.  100 - Reserved  (Rev. 3441, Issued: 01- 15-16, Effective; 12 -31-13; ASC X12: 01- 01-12, MAC Implementation: 02 -16-16; ASC X12: 02- 16-16)  100.1 - Reserved  (Rev. 3441, Issued: 01- 15-16, Effective; 12 -31-13; ASC X12: 01- 01-12, MAC Implementation: 02 -16-16; ASC X12: 02- 16-16)  110 - ESRD Method Selection  (Rev. 1, 10- 01-03)  See chapter 8, for instructions for completing the ESRD Method Selection Form.
(Medicare Claims Processing Manual)
110 - ESRD Method Selection  (Rev. 1, 10- 01-03)  See chapter 8, for instructions for completing the ESRD Method Selection Form.   110.1 - Reserved  (Rev. 3441, Issued: 01- 15-16, Effective; 12 -31-13; ASC X12: 01- 01-12, MAC Implementation: 02 -16-16; ASC X12: 02- 16-16)  120 - Reserved  (Rev. 3441, Issued: 01- 15-16, Effective; 12 -31-13; ASC X12: 01- 01-12, MAC Implementation: 02 -16-16; ASC X12: 02- 16-16)  Transmittals Issued for this Chapter  Rev #  Issue Date  Subject  Impl Date  CR#  R12423CP
(Medicare Claims Processing Manual)
Transmittals Issued for this Chapter  Rev #  Issue Date  Subject  Impl Date  CR#  R12423CP   12/20/2023 Enforcing Billing Requirements for Intensive Outpatient Program (IOP) Services with New Condition Code 92  01/02/2024 13222 R4247CP  03/01/2019 Update to Publication 100- 04 Chapters 2, 6, and 18 to Provide Language -Only Changes for the New Medicare Card Project  04/01/2019 11155 R3441CP  01/15/2016 Update to Pub. 100- 04, Chapter 02 Admission and Registration Requirements, for Provider Verification of Beneficiary Eligibility and Entitlement 02/16/2016 9457 R2971CP  05/23/2014 July 2014 Update of the Hospital Outpatient Prospective Payment System (OPPS)  07/07/2014 8776 R1472CP  03/06/2008 Update of Institutional Claims References  04/07/2008 5893 R1421CP  01/25/2008 Update of Institutional Claims References  Rescinded and Replaced by Transmittal 1472 04/07/2008 5893 R1257CP  05/25/2007 Important Message From Medicare (IM) and Expedited Determination Procedures for Hospital Discharges  07/02/2007 5622 R980CP  06/14/2006 Changes Conforming to CR 3648 Instructions for Therapy Services -  Replaces Rev. 941  10/02/2006 4014 R941CP  05/05/2006 Changes Conforming to CR 3648 Instructions for Therapy Services  10/02/2006 4014 R851CP  02/10/2006 Revisions to Instructions for Contractors Other Than the Religious Nonmedical Health Care Institutions Specialty Contractor Regarding Claims for Beneficiaries with RNCHI Elections  05/11/2006 4218 R795CP  12/30/2005 Redefined Type of Bill 14X For Non -Patient Laboratory Specimens -CR 3835 Manualization  04/03/2006 4208 R001CP  10/01/2003 Initial Publication of Manual  NA NA Back to top of Chapter
(Medicare Claims Processing Manual Crosswalk)
Medicare Claims Processing Manual Chapter 2 - Admission and Registration Requirements Crosswalk New Chap. New Sect. Int. Pub. 13 Carrier Pub. 14 HO Pub.10 SNF Pub. 12 HH Pub. 11 PM                       Other Description2 01 Purpose of Chapter2 05        Definition of Provider and Supplier 2 10 HO-300,HO-312     General Admission and Registration Rules 2 10.1 A3-3502 B3-3200,B3-3203 HO-304.4     Health Insurance Claim Numbers (HICNs) 2 10.1.1 A3-3502 B3-3205 HO-304.5     Changes to HICNs 2 10.1.2  B3-3208      Contractor Procedures for Obtaining Missing or Incorrect Claim Numbers 2 10.1.3   HO-304 SNF-404    Importance of HICNs 2 10.2   HO-302 SNF-402    Prohibition Against Waiver of Health Insurance Benefits as a Condition of Admission 2 10.3   HO-303 SNF-317    Requiring Prepayment as a Condition of Admission is Prohibited 2 10.4   HO-303.2 SNF-317    When Prepayment May Be Requested New Chap. New Sect. Int. Pub. 13 Carrier Pub. 14 HO Pub.10 SNF Pub. 12 HH Pub. 11 PM Other Description 2
(Medicare Claims Processing Manual Crosswalk)
10.4 HO-303.3 Prepayment Rules (Deductible,Coinsurance, Noncovered Services) 2 10.5   HO-300     Hospital and Skilled Nursing Facility (SNF) Verification of Prior Hospital Stay Information for Determining Deductible and Benefit Period Status 2 10.6   HO-303.3 SNF-317    Hospitals May Require Prepayment for Noncovered Services 2 10.7   HO-303,4 SNF-317    Compliance With Agreement 2 10.8 HO-266,HO-307 SNF-407    Request for Payment Should be Obtained in All Cases as Protective Application for Hospital Insurance Benefits 2 10.9   HO-308     Intermediary Requests to Verify Patient's HICN 2 10.10   HO-309     Intermediary Learns Beneficiary is an HMO Enrollee 2 10.11 HO-310 SNF-410 Retroactive Entitlement2 10.12    SNF-414    SNF Verification of Prior Hospital Stay and Transfer Requirements 2 20   HO-300 SNF-401    Obtaining Information to Determine Whether to Bill Medicare or Another Payer New Chap. New Sect. Int. Pub. 13 Carrier Pub. 14 HO Pub.10 SNF Pub. 12 HH Pub. 11 PM Other Description 2
(Medicare Claims Processing Manual Crosswalk)
20.1 HO-301 SNF-401 A-03-031 Provider Development of Medicare Secondary Payer 2 30 A3-3503 HO-304,HP-311 SNF-404    Provider/Supplier Obtaining/Verifying the HICN and Entitlement Status 2 30.1 A3-3800.2 B3-6005.2      Cross-Reference of HICN 2 30.2 A3-3501 B3-3200 HO-304.1     Health Insurance (HI) Card 2 30.3 A3-3501 B3-3200 HO-304.2     Temporary Eligibility Notice 2 30.4   HO-304.3     Certificate of Social Insurance Award 2 30.5   HO-305     Medicare Summary Notice (MSN) 2 30.6 3-3508 B3-6100      Provider Access to CMS and Carrier or Intermediary Eligibility Data 2 30.6.1 3-3508.1 B3-6100.1      Rules for Accessing Eligibility Data 2 30.6.1.1 3-3508.3       Part A Inquiry (HIQA) Screen Display 2 30.6.1.2 A3-3508.4       Part A Inquiry Reply (HIQAR) Screen Display- 2 30.6.1.3 A3-3508.5       Part A Inquiry (HUQA)Data 2 30.6.1.4 A3-3508.6       Part A Inquiry (HUQAR) Reply Data 2 30.6.1.5     HH-467.6   Health Insurance Query for Home Health Agencies HIQH) New Chap. New Sect. Int. Pub. 13 Carrier Pub. 14 HO Pub.10 SNF Pub. 12 HH Pub. 11 PM Other Description 2
(Medicare Claims Processing Manual Crosswalk)
30.6.2 B3-6100.2  Carrier Implementation2 30.6.3 B3-6100.3  Data Format2 30.6.4  B3-6100.4      Part B Eligibility Data Security Requirements 2 30.6.5  B3-6100.5      CMS Standard Part B Eligibility Inquiry Flat File Specifications 2 30.6.6  B3-6100.6      CMS Standard Part B Eligibility Response Flat File Specifications 2 30.7 Deleted2 30.8 A3-3510       Health Insurance Master Record (HIMR) Inquiry 2 30.9 A3-3511 Deleted2 30.10 A3-3512 http://cms.csc.com/cwf/downloads/docs/pdfs/overhimr.pd fBeneficiary Master Information 2   30.11 A3-3513 http://cms.csc.com/cwf/downloads/docs/pdfs/overhimr.pd fMedicare Secondary Payer Information (MSP) 2   30.12 A3-3514 http://cms.csc.com/cwf/downloads/docs/pdfs/overhimr.pd fGroup Health Organization (GHO) 2   30.13 A3-3515 http://cms.csc.com/cwf/downloads/docs/pdfs/overhimr.pd fHospice Enrollment 2   30.14 A3-3516 http://cms.csc.com/cwf/downloads/docs/pdfs/overhimr.pd fSurgery Information 2   30.15 A3-3517 http://cms.csc.com/cwf/downloads/docs/pdfs/overhimr.pd fEnd Stage Renal Disease (ESRD) New Chap. New Sect. Int. Pub. 13 Carrier Pub. 14 HO Pub.10 SNF Pub. 12 HH Pub. 11 PM Other Description 2   30.16 A3-3518 http://cms.csc.com/cwf/downloads/docs/pdfs/overhimr.pd fBeneficiary Cross-Reference 2   30.17 A3-3519
(Medicare Claims Processing Manual Crosswalk)
A3-3518 http://cms.csc.com/cwf/downloads/docs/pdfs/overhimr.pd fBeneficiary Cross-Reference 2   30.17 A3-3519 http://cms.csc.com/cwf/downloads/docs/pdfs/overhimr.pd fDMEPOS Certificate of Medical Necessity (CMN) Display 2   30.18 A3-3520 http://cms.csc.com/cwf/downloads/docs/pdfs/overhimr.pd fTrue Not In File (TNIF) Status 2   30.19 A3-3521 http://cms.csc.com/cwf/downloads/docs/pdfs/overhimr.pd fClaim History Information 2  30.19.1  A3-3521.1 http://cms.csc.com/cwf/downloads/docs/pdfs/overhimr.pd fInpatient History Overview 2  30.19.2  A3-3521.2 http://cms.csc.com/cwf/downloads/docs/pdfs/overhimr.pd fOutpatient/HHA History Inquiries 2  30.19.3  A3-3521.3 http://cms.csc.com/cwf/downloads/docs/pdfs/overhimr.pd fHospice History 2  30.19.4  A3-3521.4 http://cms.csc.com/cwf/downloads/docs/pdfs/overhimr.pd fPart B History 2   30.20 A3-3522 http://cms.csc.com/cwf/downloads/docs/pdfs/overhimr.pd fArchived History Information 2 30.21 A3-3523 B3-6008      Requesting Assistance in Resolving Problem Areas in the Inquiry/Inquiry Response Procedures 2 30.21.1 A3-3523.1       HMO-Related Master File Corrections 2 30.22   HO-300     Provider Problems Obtaining Entitlement Information 2         50 Critical Case Procedures - Establishing Entitlement Under Part A and B  New Chap. New Sect. Int. Pub. 13 Carrier Pub.
(Medicare Claims Processing Manual Crosswalk)
Master File Corrections 2 30.22   HO-300     Provider Problems Obtaining Entitlement Information 2         50 Critical Case Procedures - Establishing Entitlement Under Part A and B  New Chap. New Sect. Int. Pub. 13 Carrier Pub. 14 HO Pub.10 SNF Pub. 12 HH Pub. 11 PM Other Description 2 60   HO-306     Provider Contacts with the SSO to Obtain the HICN 2 60.1   HO-306.1     Information Required by the Social Security Office 2
(Medicare Claims Processing Manual Crosswalk)
60.2 HO-306.2 The SSO Reply2 70        SSO Assistance in Resolving Entitlement Status Problems 2 80   HO-312     Required Hospital Notice to Beneficiaries 2 80.1   HO-312A     Notice to Beneficiaries of QIO Review of Care 2 80.2   HO-312B     Notice to Beneficiary of QIO of Need for Continued Hospitalization 2 80.3   HO-312.1     QIO Monitoring of Hospital Admission Notice to Beneficiaries 2 90 HO-350 Outpatient Hospital RegistrationProcedures 2 90.1 HO-350A Patient Identification2 90.2   HO-350B     Determining Whom to Bill 2 90.3   HO-350C     Source of Admission - Outpatient Hospital 2 90.4 HO-350D Type of BillNew Chap. New Sect. Int. Pub. 13 Carrier Pub. 14 HO Pub.10 SNF Pub. 12 HH Pub. 11 PM Other Description 2 90.5   HO-350E     Definition of Diagnostic Services 2                                       90.6 HO-350F Definition of Encounter2 100       HSP-201 Hospice Notice of Election 2 100.1        FI Reply to Notice of Election 2 100.1.3       HSP-302.2 FI Reply to Notice of Election 2 110 ESRD Method Selection2 110.1        ESRD Method of Selection Transaction to CWF and Response 2 120        Religious Nonmedical Health Care Institution (RNHCI) Admission 2 120.1 AB-00-30 Election Requirements2 120.2 AB-00-30 Revocation of Election2 120.3      AB-00-30  Completion of the Uniform (Institutional Provider) Bill (Form CMS-1450) Notice of Election for RNHCI 2 120.4      AB-00-30  Common Working File (CWF)
(Medicare Claims Processing Manual)
Medicare Claims Processing Manual  Chapter 3 - Inpatient Hospital Billing   Table of Contents  (Rev. 12306, Issued:  10-19-23)    Transmittals for Chapter 3
(Medicare Claims Processing Manual)
10 - General Inpatient Requirements  10.1 - Claim Formats  10.2 - Focused Medical Review (FMR)  10.3 - Spell of Illness  10.4 - Payment of Nonphysician Services for Inpatients  10.5 - Hospital Inpatient Bundling  20 - Payment Under Prospective Payment System (PPS) Diagnosis Related Groups (DRGs)  20.1 - Hospital Operating Payments Under PPS  20.1.1 - Hospital Wage Index  20.1.2 - Outliers  20.1.2.1 - Cost to Charge Ratios  20.1.2.2 - Statewide Average Cost to Charge Ratios  20.1.2.3 - Threshold and Marginal Cost  20.1.2.4 - Transfers  20.1.2.5 - Reconciliation  20.1.2.6 - Time Value of Money  20.1.2.7 - Procedure for Medicare contractors to Perform and Record Outlier Reconciliation Adjustments  20.1.2.8 - Specific Outlier Payments for Burn Cases  20.1.2.9 - Medical Review and Adjustments 20.1.2.10 - Return Codes for Price r 20.2 - Computer Programs Used to Support Prospective Payment System  20.2.1 - Medicare Code Editor (MCE)  20.2.1.1 - Paying Claims Outside of the MCE  20.2.1.1.1 - Requesting to Pay Claims Without MCE Approval  20.2.1.1.2 - Procedures for Paying Claims Without Passing through the MCE  20.2.2 -  DRG GROUPER Program  20.2.3 -  PPS Pricer Program  20.2.3.1 -  Provider -Specific Fil e 20.3 -  Additional Payment Amounts for Hospitals with Disproportionate Share of Low -Income Patients  20.3.1 -  Clarification of Allowable Medicaid Days in the Medicare Disproportionate Share Hospital (DSH) Adjustment Calculation  20.3.1.1 -  Clarification for Cost Reporting Periods Beginning On or After January 1, 2000 20.3.1.2 -  Hold Harmless for Cost Reporting Periods Beginning Before January 1, 2000  20.3.1.3 -  Disproportionate Share Hospital (DSH) Policy Changes Effective for Cost Reporting Periods beginning on or after October 1, 2009 20.3.1.4 -  Disproportionate Share Hospital (DSH) Policy Changes Effective for Cost
(Medicare Claims Processing Manual)
Share Hospital (DSH) Policy Changes Effective for Cost Reporting Periods beginning on or after October 1, 2009 20.3.1.4 -  Disproportionate Share Hospital (DSH) Policy Changes Effective for Cost Reporting Periods beginning on or after October 1, 2012 20.3.2 -  Updates to the Federal Fiscal Year (FY) 2001  20.3.2.1 -  Inpatient Hospital Payments and Disproportionate Share Hospital (DSH) Thresholds and Adjustments  20.3.3 -  Prospective Payment Changes for Fiscal Year (FY) 2003  20.3.4 -  Prospective Payment Changes for Fiscal Year (FY) 2004 and Beyond 20.4 -  Hospital Capital Payments Under PPS  20.4.1 -  Federal Rat e 20.4.2 -  Hold Harmless Payments  20.4.3 -  Blended Payments  20.4.4 -  Capital Payments in Puerto Rico  20.4.5 -  Old and New Capital  20.4.6 -  New Hospitals  20.4.7 -  Capital PPS Exception Payments  20.4.8 -  Capital Outliers  20.4.9 -  Admission Prior to and Discharge After Capital PPS Implementation Date  20.4.10 -  Market Basket Update  20.5 -  Rural Referral Centers (RRCs) 20.6 -  Criteria and Payment for Sole Community Hospitals and for Medicare Dependent Hospitals  20.7 -  Billing Applicable to PPS  20.7.1-  Stays Prior to and Discharge After IPPS Implementation Date  20.7.2 -  Split Bills  20.7.3 -  Payment for Blood Clotting Factor Administered to Hemophilia Inpatients  20.7.4 -  Cost Outlier Bills With Benefits Exhausted  20.8 -  Payment to Hospitals and Units Excluded from IPPS for Direct Graduate Medical Education (DGME) and Nursing and Allied Health (N&AH) Education for Medicare Advantage (MA) Enrollees  30 - Medicare Rural Hospital Flexibility Program and Critical Access Hospitals (CAHs)  30.1 -  Requirements for CAH Services, CAH Skilled Nursing Care Services and Distinct Part Units  30.1.1 -  Payment for Inpatient Services Furnished by a CAH  30.1.1.1 -  Payment for Inpatient Services Furnished by an Indian Health Service (IHS) or tribal CAH  30.1.2 -  Payment for Post -Hospital SNF Care Furnished by a CAH  30.1.3 -  Costs of Emergency Room On- Call Providers
(Medicare Claims Processing Manual)
Services Furnished by an Indian Health Service (IHS) or tribal CAH  30.1.2 -  Payment for Post -Hospital SNF Care Furnished by a CAH  30.1.3 -  Costs of Emergency Room On- Call Providers  30.1.4 -  Costs of Ambulance Service s 40 - Billing Coverage and Utilization Rules for PPS and Non- PPS Hospitals  40.1 -  "Day Count" Rules for All Providers  40.2 -  Determining Covered/Noncovered Days and Charges  40.2.1 -  Noncovered Admission Followed by Covered Level of Care  40.2.2 -  Charges to Beneficiaries for Part A Services  40.2.3 -  Determining Covered and Noncovered Charges -  Pricer and PS&R  40.2.4 -  IPPS Transfers Between Hospitals  40.2.5 -  Repeat Admissions  40.2.6 -  Leave of Absence 40.3 -  Outpatient Services Treated as Inpatient Services  40.3.1 -  Billing Procedures to Avoid Duplicate Payments  50 - Adjustment Bills  50.1 -  Tolerance Guidelines for Submitting Adjustment Requests  50.2 -  Claim Change Reasons  50.3 -  Late Charges  60 - Swing -Bed Services  70 - All-Inclusive Rate Providers  70.1 -  Providers Using All -Inclusive Rates for Inpatient Part A Charges  80 - Hospitals That Do Not Charge  80.1 -  Medicare Summary Notice (MSN) for Services in Hospitals That Do Not Charge  90 - Billing Transplant Services  90.1 -  Kidney Transplant -  General  90.1.1 -  The Standard Kidney Acquisition Charge  90.1.2 -  Billing for Kidney Transplant and Acquisition Services  90.1.3 -  Billing for Donor Post -Kidney Transplant Complication Services  90.2 -  Heart Transplants  90.3 -  Stem Cell Transplantation  90.3.1 -  Allogeneic  for Stem Cell Transplantation  90.3.2 -  Autologous Stem Cell Transplantation (AuSCT)  90.4 -  Liver Transplants  90.4.1 -  Standard Liver Acquisition Charge  90.4.2 -  Billing for Liver Transplant and Acquisition Services  90.5 -  Pancreas Transplants With Kidney Transplants  90.5.1 -  Pancreas Transplants Alone (PA)  90.6 -  Intestinal and Multi- Visceral Transplants  100 -  Billing Instructions for Specific Situations  100.1 -  Billing for Abortion Services  100.2 -  Payment for CRNA or AA Services  100.3 -  Resident and Interns Not Under Approved Teaching Programs
(Medicare Claims Processing Manual)
-  Intestinal and Multi- Visceral Transplants  100 -  Billing Instructions for Specific Situations  100.1 -  Billing for Abortion Services  100.2 -  Payment for CRNA or AA Services  100.3 -  Resident and Interns Not Under Approved Teaching Programs  100.4 -  Billing for Services After Termination of Provider Agreement  100.4.1 -  Billing Procedures for a Provider Assigned Multiple Provider Numbers or a Change in Provider Number  100.5 -  Review of Hospital Admissions of Patients Who Have Elected Hospice Care  100.6 -  Inpatient Renal Services  100.7 -  Lung Volume Reduction Surgery  100.8 -  Replaced Devices Offered Without Cost or With a Credit  100.9  Requirements for Processing Non Veterans Administration (VA) Authorized Inpatient Claims  100.10  Requirements  for Processing  Programs of All -Inclusive Care for the Elderly (PACE) Disenrollments during an  Inpatient  Stays 130 -  Coordination With the Quality Improvement Organization (QIO)  140 -  Inpatient Rehabilitation Facility Prospective Payment System (IRF PPS)  140.1 -  Medicare IRF Classification Requirements  140.1.1 -  Crite ria That Must B e Met By Inpatient Rehabilitation Facilities  140.1.2 -  Additional Criteria That Must Be Met By Inpatient Rehabilitation Units  140.1.3 -  Verification Process Used to Determine if the Inpatient Rehabilitation Facility Met the Classification Criteria  140.1.4 -  New IRFs  140.1.5 -  Changes in the Status of an IRF Unit  140.1.6 -  New IRF Beds  140.1.7 -  Change of Ownership or Leasing 140.1.8 -  Mergers  140.1.9 -  Retroactive Adjustments For Provisionally Excluded IRFs or IRF Beds  140.2 -  Payment Provisions Under IRF PPS  140.2.1 -  Phase- In Implementation  140.2.2 -  Payment Adjustment Factors and Rates  140.2.3 -  Case- Mix Groups  140.2.4 -  Case- Level Adjustments  140.2.5 -  Facility -Level Adjustments  140.2.5.1 -  Area Wage Adjustments  140.2.5.2 -  Rural Adjust ment 140.2.5.3 -  Low-Income Patient (LIP) Adjustment: The S upplem ental S ecurity Income (SSI)/Medicare Beneficiary Data for Inpatient Rehabilitation Fac ilities (IRFs) Paid Under the P rospective Payment System ( PPS)  140.2.5.4 -  Teaching Status Adjus