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Completing The UB-04 Claim Form – Introduction Practice Test

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HIPPS rate codes are used for payment determinations under several prospective payment systems. Which is an example of systems where HIPPS are used?
Correct Answer:
Skilled Nursing Facilities, Inpatient Rehabilitation Facilities, and Home Health Agencies
Explanation:
HIPPS codes are used to determine payment amounts under certain post-acute prospective payment systems. The correct example includes Skilled Nursing Facilities, Inpatient Rehabilitation Facilities, and Home Health Agencies because these settings all use HIPPS-based PPS to establish payment rates based on patient characteristics and resource use. General acute care hospitals are paid with DRGs, not HIPPS; outpatient clinics rely on outpatient prospective payment methods or APCs rather than HIPPS; and pharmacy benefit managers operate in drug benefits rather than PPS payment systems. So, the settings listed are the ones where HIPPS rate codes drive payment determinations.

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