What is the purpose of Pricing Extensions?

• A. Determine the reimbursement using a method other than the standard payment mechanisms
• B. Set the per diem
• C. Adjust the description
• D. Define eligibility

Answer: (B)

Pricing Extensions are used to establish daily payment amounts, i.e., a per diem, for care. This allows reimbursement to be based on each day of an inpatient stay rather than on individual procedure-by-procedure charges, which is especially common in contracts that pay a fixed daily rate. It streamlines pricing and ensures the daily rate covers room, meals, and standard services. It isn’t about choosing an alternate reimbursement method, changing service descriptions, or deciding eligibility.