Medicare payment for a client admitted to the hospital is determined by a system that bases its payment on the actual diagnosis known as diagnosis-related groups (DRGs). This classification system pays a provider by:
1. The total cost for the care provided.
2. An average of the total costs.
3. The usual and customary charge.
4. A set amount for a specific condition.
4
Explanation: 1. Medicare payment for inpatient services is made at a predetermined specific rate for each
Medicare recipient based on the patient?s diagnosis. Care is classified into diagnosis -related
groups (DRGs). The total cost is the bill for the care that was rendered. An average for the costs
is not a payer source used by the health care industry. The usual and customary charge is a
term payers use to determine the appropriate costs for a procedure.
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