| ACRONYM |
STANDS FOR |
MEANING |
| ICD9 |
International Classification of Diseases, 9th Edition |
A system designed to standardize health care diagnoses for
reimbursement purposes |
| CPT Code |
Current Procedural Terminology Code |
A system designed by the American Medical Association to
reimburse specific units of health care services |
| OBRA |
Omnibus Budget Reconciliation Act |
Congressional acts which frequently have legislation related to health care |
| RBRVS |
Resource-based-relative-value scale |
Complex federal regulations which rate health care activities for Medicare Part B reimbursement |
| RVU |
Relative Value Unit |
A unit of health care which is specifically reimbursed according
to rates set by HCFA and vary according to level of care and
geographical area |
| SNF |
Skilled Nursing Facility |
A facility such as a nursing home; nursing reimbursement is permitted under specific regulations |
| DRGs |
Diagnostic-related groupings |
A predetermined payment to a hospital based on the patient diagnosis |
| HCFA |
Health Care Financing Agency |
Federal agency which determines rules and regulations for health care reimbursement policy |
| TEFRA |
Tax Equity and Fiscal Responsibility Act |
Federal regulations which allow states to reimburse health care
for special populations according to their needs through a system of
waivers |
| EPSDT |
Early Periodic Screening and Developmental Testing |
A federal program for health monitoring up to age 21 years |
| PPRC |
Physician Payment Review Commission |
Agency which determines Medicare reimbursement rates and regulations |
| PCPs |
Primary Care Providers |
Health care professionals who are in ongoing relationships with the patients |
| PPS |
Prospective Payment System |
A capitated reimbursement plan that provides payment based on designated amount per enrollee per year |
| CHAMPUS |
Civilian Health and Medical Program of the United States |
Plan which provides health care to military personnel and their families and reimburses NPs |
| FEHBP |
Federal Employee Health Benefit Plan |
Group insurance plan of federal employees and their dependants which
recognizes APNs as providers |
| PMAP |
Prepaid Medical Assistance Program |
Managed care system for Medicare populations which includes all services
such as prevention, care, transportation, interpreter services, etc |
| FQHC |
Federally-Designated Clinics or Federally-Qualified Health Clinics |
Clinics located in urban or rural underserved areas to improve access to care for specific populations |
