PMSI/T2A MCO Valorisation Updates
Key Questions
What are the main PMSI-based calculations for MCO activity funding?
SNDS documents detail PMSI calculations including GHM/GHS tariffs, ONDAM, reste à charge post-AMO, and EXH/EXB. These are essential for accurate DAF/DIM reimbursement. Annual ATIH guides provide key guidance on these elements.
Why are ATIH guides emphasized for PMSI/T2A MCO valorisation?
ATIH guides, such as the 2025 Guide de lecture des tableaux de contrôle ENC HAD, focus on Tableaux 3: Données PMSI to improve medical data quality control. They support reimbursement accuracy without major 2023+ reforms. This development aids DAF/DIM processes.
How do supplements factor into GHS billing under PMSI/T2A?
Chapitre 4 (Articles 7 à 8) on Légifrance outlines facturation de suppléments en sus de GHS, billed additionally to standard tariffs. This integrates with PMSI-based MCO funding calculations. It ensures precise valorisation alongside GHM/GHS components.
SNDS docs detail PMSI-based calcs for MCO activity funding (GHM/GHS tariffs, ONDAM, reste à charge post-AMO, EXH/EXB). Essential for DAF/DIM reimbursement accuracy; annual ATIH guides emphasized, no 2023+ reform breakthroughs.