Low Volume Adjustment

As a Sole Community Hospital or a Medicare Dependent Hospital, your facility may be eligible for a Low Volume Adjustment for Medicare PPS. This adjustment was designed to make fair payments to providers by covering the costs of an efficient provider and adjusting for factors which a provider should not be held accountable.

In order to qualify for payment reimbursement, your facility must have a decrease in discharges greater than 5 percent due to an unusual situation or occurrence externally. This may consist of strikes, floods, inability to recruit staff, building reconstruction, severe weather conditions or economic recessions.

Additional criteria to qualify for a Low Volume Adjustment includes:

A high physician turnover
A shift in outpatient and inpatient
Nurses being classified incorrectly
Losses on Medicare inpatient services
A decrease in discharges, beyond the Hospital’s control

With over 20 successful intermediary negotiations for obtaining identified payment adjustments, The Rybar Group consultants are available to provide you with a FREE assessment of your facility's qualification. By reviewing your cost reports and a copy of your facilities FTE by Cost Center, we will work to identify your potential reimbursement.

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