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Health Insurance Prospective Payment System

Abbreviation: HIPPS

Definition

The Health Insurance Prospective Payment System (HIPPS) is a payment methodology used in the United States for reimbursing skilled nursing facilities (SNFs) under Medicare Part A. HIPPS determines the payment rate based on the resident’s resource utilization group (RUG) classification, which considers factors such as the resident’s clinical condition, care needs, and therapy requirements. HIPPS promotes standardized and equitable payment for SNF services while considering the individual needs of residents.