When the cost of treating a patient exceeds the payment for the MS-DRG by a certain amount, Medicare will increase the payment.

Name: When the cost of treating a patient exceeds the payment for the MS-DRG by a certain amount, Medicare will increase the payment.
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Medicare provides additional payments, known as outlier payments, when the cost of treating a patient significantly exceeds the standard MS-DRG payment to protect hospitals from financial losses.

When the Cost of Treating a Patient Exceeds the Payment