Medicare A & B Common Acronyms

We make every effort to define all Medicare Program terminology that you may encounter on our web site. In the event that you need additional definitions, we have compiled the following list of acronyms to assist you.

The Centers for Medicare & Medicaid Services' also offers an online acronym list.

A | B | C | D | E | F | G | H | I | J | K | L | M | N | O | P | Q | R | S | T | U | V | W | X | Y | Z

Acronym	Phrase
A	Assigned (claim)
AA	Anesthesia Assistant
AAHAM	American Association of Healthcare Administrative Management
AAO	Associate Administrator for Operations
AAP	Associate Administrator for Policy
AAPC	American Academy of Professional Coders
AAPCC	Adjusted Average Per Capita Rate
AARP	American Assoc. of Retired Persons
ABN	Advance Beneficiary Notice
ACER	Annual Contractor Evaluation Report
ACF2	Access Control Facility
ACH	Acute Care Hospital
ACMS	Automated Change Management System
ACN	Attachment Control Number
ACP	Advance Care Planning
ACPS	Advanced Claims Processing System
ACR	Adjusted Community Rate
ADA	American Dental Association
ADP	Automated Data Processing
ADR	Automated Desk Review
ADR	Additional Development Request
AGPAM	American Guild of Patient Account Managers
AHA	American Hospital Association
AHCA	American Health Care Association
AHCPR	Agency for Health Care Policy and Research
AIR	All Inclusive Rate
ALJ	Administrative Law Judge
ALS	Advanced Life Support
AMA	American Medical Association
AMMIS	Arizona Medicare Management Information System
ANSI	American National Standards Institute
AP	Appeals Department
APASS	Arkansas Part A Standard System
APC	Ambulatory Payment Classification
APG	Ambulatory Patient Group
APP	Application Portability Profile
APS	Adjudication Payment System
AQRP	Audit Quality Review Program
ARA	Associate Regional Administrator
ARD	Assessment Reference Date
ARU	Audio/Automated Response Unit
ASA	American Society of Anesthesiologists
ASC	Ambulatory Surgical Center
ASC	Accredited Standards Committee
ASCA	Administrative Simplification Compliance Act
ASCQR	Ambulatory Surgical Center Quality Reporting Program
ASP	Average Sales Price
AUSA	Assistant United States Attorney
AWAS	Automated Work Administration System
AWV	Annual Wellness Visit
Back to Top
BAC	Beneficiary Advisory Committee
BAU	Bill Adjustment Unit
BBA	Balanced Budget Act
BCBS	Blue Cross Blue Shield
BCRC	Benefits Coordination and Recovery Center
BDF	Bulk Data Facility
BDMS	Bureau of Data Management Systems
BEA	Budget Expense Account Unit
BENE	Beneficiary
BHI	Bureau of Health Insurance
BI	Benefit Integrity
BIB	Benefits Integrity Branch
BIP	Bill in Process
BIPIS	"Bill in Progress, Inpatient/SNF Report"
BIPOR	"Bill in Progress, Outpatient/RHC Report"
BIS	Benefit Integrity System (Novitas Solutions)
BLS	Basic Life Support
BLS	Bureau of Labor Statistics
BLU/C	Bottom Line Unit Cost
BMA	Bio-Medical Association
BMACS	Part B Medicare Automated Claims Section
BMAD	Part B Medicare Annual Data
BOA	Billing Office Approver
BOBA	Billing Office Backup Approver
BOC	Business Office Coordinators
BPA	Bureau of Program Administration
BPD	Bureau of Policy Development
BPO	Bureau of Program Operations (CMS)
BPR	Budget and Performance Requirements
BPRSC	Budget Performance Requirements Survey of Compliance
BT	Bill Type
BUD	Beneficiary Utilization Data File
Back to Top
CABS	Carrier Access Billing System
CAC	Carrier Advisory Committee
CAFM	Contractor Administration Budget and Financial Management System
CAH	Critical Access Hospital
CAI	Computer Aided Instruction
CAMS	Customer Account Mgmt. System
CAP	Competitive Acquisition Program
CAP	Corrective Action Plan
CAPD	Continuous Ambulatory Peritoneal Dialysis
CAR	Comparative Analysis Report
CARC	Claim Adjustment Reason Code
CAS	Claim Adjustment Segment
CASE	Computer Assisted Software Engineering
CASF	Carrier Alphabetic State File
CASR	Contractor Audit and Settlement Report
CB	Consolidated Billing
CBR	Cost Benefit Ratio
CBR	Comparative Billing Report
CBR	CASE Based Reasoning
CBS	Center for Beneficiary Services
CBSA	Core Based Statistical Areas
CBSS	Customer Billing Services System
CBT	Computer Based Training
CC	Chief Compliant
CC	Condition Code
CCEs	Coordinated Care Entities
CCI	Correct Coding Initiative
CCM	Chronic Care Management
CCN	Correspondence Control Number
CCR	Cost Classification Report
CDC	Centers for Disease Control and Prevention
CELIP	Claim Expansion Line Item Processing
CER	Clerical Error Reopening
CERT	Comprehensive Error Rate Testing Program
CF	Conversion Factor
CFR	Code of Federal Regulations
CHAMPUS	Civilian Health and Medical Program of Uniformed Services
CHAMPVA	Civilian Health and Medical Program of Veterans Administration
CHD	Coronary Heart Disease
CHECC	Consumer Health Education Coordination Committee
CHOP	Coalition of Hematology Oncology Practices
CHOW	Change of Ownership
CI	Complexity Index
CICS	Customer Information Control System
CJR	Comprehensive Care for Joint Replacement
CLCCP	Comprehensive Limiting Charge Compliance Program
CLIA	Clinical Laboratory Improvements Amendments of 1998
CMG	Case Mix Group
CMHC	Community Mental Health Center
CMN	Certificate of Medical Necessity
CMP	Civil Monetary Penalty
CMPL	Civil Monetary Penalty Law
CMR	Comprehensive Medical Review
CMS	Centers for Medicare and Medicaid Services
CNS	Clinical Nurse Specialist
CO	"Central Office (CMS in Baltimore, MD)"
COB	Close of Business
COB	Coordination of Benefits
COBRA	Consolidated Omnibus Budget Reconciliation Act of 1986
CORF	Comprehensive Outpatient Rehabilitation Facility
CORTS	COMDISCO Plan Automation System
COTR	Contracting Officer's Technical Representative
COTS	Commercial Off-the-Shelf
CP	Clinical Psychologist
CP & BI TAG	Claims Processing and Benefit Interpretation Technical Advisory Group
CPC	Certified Professional Coder
CPCM	Claims Processing Coding Manual
CPE	Contractor Performance Evaluation
CPEP	Contractor Performance Evaluation Program
CPI	Consumer Price Index
CPM	Critical Path Method
CPO	Care Plan Oversight
CPR	Contingency Plan Report
CPT	Claims Processing Timeliness
CPT	Current Procedure Terminology
CPT-4	Current Procedure Terminology - 4th Edition
CPU	Central Processing Unit
CR	Change Request
CRB	Change Review Board
CRD	Chronic Renal Disease
CREP	Cost Report Evaluation Program
CRIHB	California Rural Indian Health Board
CRNA	Certified Registered Nurse Anesthetists
CROWD	Contractor Reporting of Operational and Workload Data
CRT	Cathode Ray Tube
CS	Customer Service Department
CSPS	Cost/Scheduling Performance System
CSSR	Communications System Segment Replacement
CSTP	Carrier Systems Testing Program
CSW	Clinical Social Worker
CTMP	Contractor Task Management Plan
CTV	Closed-circuit Television
CUI	Customer User Interface
CWF	Common Working File
CWFM	Common Working File Maintenance
CWR	Carrier Workload Report
CY	Calendar Year
CYE	Calendar Year End
Back to Top
DAC	Division of Acute Care
DAP	Data Administration Plan
DASD	Direct Access Storage Device
DC	Data Communications
DCN	Document Control Number
DCNS	Documentation Control Number Selector
DCP	Department of Carrier Procedures
DDE	Direct Data Entry
DDL	Data Definition Language
DDS	Doctor of Dental Surgery
DEC	Digital Equipment Corporation
DEDUCT	Deductible
DEFRA	Deficit Reduction Act of 1984
DFD	Data Flow Diagram
DFO	Division of Financial Operations
DHHS	Department of Health and Human Services
DHSQ	Division of Health Standards and Quality
DIH	Days In House
DLS	Date Last Seen
DMD	Doctor of Medical Dentistry
DME	Direct Medical Education
DME	Durable Medical Equipment
DMEPOS	Durable Medical Equipment, Prosthetics, Orthotics and Supplies
DMERC	Durable Medical Equipment Regional Contractor
DMP	Drug Management Program
DO	Doctor of Osteopathy
DOB	Date of Birth
DOC	Documentation
DOD	Date of Death
DOJ	Department of Justice
DOR	Date of Receipt
DOS	Date of Service
DOS	Division of Operational Systems
DOSD	Division of Operational Systems Development
DPA	Division of Provider Audit
DPE	Division of Performance Evaluation
DPM	Deputy Program Manager
DPM	Doctor of Podiatric Medicine
DPO	Division of Program Operations
DPP	Division of Provider Procedures
DPRP	Diabetes Prevention Recognition Program
DPSCP	Division of Provider Service Coverage Policy
DRG	Diagnosis-Related Group
DSAF	CMS' Decision Support Access Facility
DSCN	Data Services Centers and Networks
DSH	Disproportionate Share Hospital
DSMS	Development and Support Management System
DSP	Design Specification Package
DX	Diagnosis
Back to Top
EACH	Essential Access Community Hospital
ECG	Electrocardiogram
ECNI	"Enterprise Communication Network, Inc."
ECR	Electronic Cost Report
ECRS	Electronic Correspondence Referral System
ED	Emergency Department
EDI	Electronic Data Interchange
EFT	Electronic Funds Transfer
EGHP	Employer Group Health Plan
EGLHP	Employer Group Large Health Plan
EHR	Electronic Health Records
EI	Economic Index
EID	Employment Information Data
IDM	Identity Management System
EIN	Employer Identification Number
EKG	Electrocardiogram
EKMS	Electronic Key Management System
E/M	Evaluation and Management Procedure(s)
EMC	Electronic Media Claim
EMC	Electronic Medical Claim
ENOA	Elimination Notice of Admission
EOB	Explanation of Benefits
EOMB	Explanation of Medicare Benefits
EPO	Epoetin (an injection)
EPO	Erythropoietin
ERA	Electronic Remittance Advice
ERD	Entity Relationship Diagram
ERISA	Employee Retirement Income Security Act
ERN	Electronic Remittance Notice
eRx	Electronic Prescribing
esMD	Electronic Submission of Medical Documentation
ESRD	End Stage Renal Disease
EWUs	Equivalent Work Units
Back to Top
F&A	Fraud and Abuse
FACP	Final Administrative Cost Proposal
FAQ	Frequently Asked Questions
FAR	Federal Acquisition Regulation(s)
FBI	Federal Bureau of Investigation
FCA	False Claims Act
FDA	Food and Drug Administration
FEP	Front End Processor
FFS	Fee - for - Service
FH	Fair Hearing
FHIBA	Federal Health Insurance Benefits Account
FI	Field Investigation
FI	Fiscal Intermediary
FICA	Federal Insurance Contributions Act
FID	Fraud Investigation Database (CMS)
FIFO	First In First Out
FIG	Fiscal Intermediary Group
FIM	Functional Independence Measure
FIPS	Federal Information Processing Standards
FIRMR	Federal Information Resources Management Regulation
FISS	Fiscal Intermediary Standard (or Shared) System
FMFIA	Federal Manager's Financial Integrity Act
FMR	Focused Medical Review
FO	Social Security Administration Field Office
FOBT	Fecal-Occult Blood Tests
FOI	Freedom of Information
FOIA	Freedom of Information Act
FPLOE	Fixed Price Level of Effort
FPR	Federal Procurement Regulations
FQHC	Federally Qualified Health Center
FR	Final Rule
FRC	Federal Records Center
FRG	Federal Relations Group
FSCC	Freestanding Cardiac Catharization Facility
FSS	Florida Shared System
FTB	First Time Beneficiary (Medicare Secondary Payer)
FTE	Full Time Equivalents
FY	Fiscal Year
FYE	Fiscal Year End
Back to Top
GAMSS	General American Medicare Standard System
GAO	General Accounting Office
GBU	Government Business Unit
GEHA	Government Employees Hospital Association
GFR	Government Furnished Resources
GHP	Group Health Plan
GI	General Inquiry
GOSIP	Government Open Systems Interconnection Profile
GPCI	Geographic Practice Cost Index
GPPPs	Group Practice Prepayment Plans
GTEMS	GTE Medicare System
GUI	Graphic User Interface(s)
Back to Top
HAASC	Hospital Affiliated Ambulatory Surgical Center
HAP	Hospital Association of Pennsylvania
HBP	Hospital Based Physician
HCFA	Health Care Financing Administration
HCPCS	Healthcare Common Procedure Coding System
HCRIS	Hospital Cost Report Information System
HCV	Hepatitis C Virus
HCWP	Hospital Council of Western Pennsylvania
HDC	HCFA Data Center
HER	"Health Economics Research, Inc."
HETS	HIPAA Eligibility Transaction System
HFMA	Healthcare Financial Management Association
Novitas	Novitas Solutions
HHA or HH	Home Health Agency
HHS	Health and Human Services
HI	Hospital Insurance
HIB	Health Insurance Benefit Care
HIBC	High Intensity Behavioral Counseling
HICN	Health Insurance Claim Number; also HIC Number
HIGLAS	Healthcare Integrated General Ledger Accounting System
HIM	Health Insurance Manual
HIMR	Health Insurance Master Record
HINN	Health Insurance Notice of Non-Coverage
HIPAA	Health Insurance Portability and Accountability Act
HIPPS	Health Insurance Prospective Payment System
HIQA	Health Insurance Query Access
HIS	Health Information Systems
HISDG	HCFA Information Systems Development Guide
HMO	Health Maintenance Organization
Novitas	Highmark Medicare Services
HPBSS	HCFA Part B Standard System
HPI	History of Present Illness
HPSA	Health Professional Shortage Area
HR	Host Response
HRSA	Health Resources and Services Administration
HSI	Health Systems International
HSQ	Health Standards and Quality
HSQB	Health Survey Quality Board
HSQB	Health Standards Quality Bureau
Back to Top
I&A	Identity and Access
I&R	Intern and Resident
I.H.S.	Indian Health Service
IBPR	Intermediary Benefit Payment Report
ICAM	Integrated Computer Aided Manufacturing
ICD	Interface Control Document
ICD	International Classification of Diseases
ICD-9-CM	"International Classification of Diseases 9th Review, Clinical Modifications"
ICD-10-CM	International Classification of Diseases, 10th Revision, Clinical Modifications
ICN	Intermediary Control Number
ICU	Intensive Care Unit
IDE	Investigational Devices Exemption
IDG	Interdisciplinary Group
IDTF	Independent Diagnostic Testing Facility
IEQ	Initial Enrollment Questionnaire
IER	Interim Expenditure Report
IFB	Invitation For Bid
IIC	Inflation Index Charge - Customary
IIN	IBM Information Network
IIP	Inflation Index Charge - Prevailing
IL	Independent Laboratory
IM	Intramuscular
IME	Indirect Medical Education
IOM	Internet Only Manual
IOR	Individual Operating Report
IP	Inpatient
IPA	Individual Practice Association
IPC	Information Processing Center(s)
IPD	Intermittent Peritoneal Dialysis
IPF	Inpatient Psychiatric Facility
IPPE	Initial Preventive Physical Examination
IPPS	Inpatient Prospective Payment System
IPRS	Improper Payment Reduction Strategy
IR	Incident Report
IRB	Institutional Review Board
IRC	Internal Revenue Code
IRDS	Information Resource Dictionary System
IRF	Inpatient Rehabilitation Facility
IRF-PAI	Inpatient Rehabilitation Facility Patient Assessment Instrument
IRM	Information Resources Management
IRS	Internal Revenue Service
ISTP	Intermediary Systems Testing Project
ITC	Interdisciplinary Team Conference
ITS	Inspection Tracking System
IV	Intravenously
IV&V	Independent Verification and Validation
IVD	Interactive Video Disk
IWMB	Information Workload Management Branch
IVR	Interactive Voice Response Unit
IWR	Intermediary Workload Report
Back to Top
JAD	Joint Application Design
JCL	Job Control Language
KePRO	Keystone Peer Review Organization (Pennsylvania)
LAN	Local Area Network
LBN	Legal Business Name
LCD	Local Coverage Determination
LCER	Limiting Charge Exception Report
LFS	Lab Fee Schedule
LGHP	Large Group Health Plan
LIFO	Last In First Out
LLC	Limited Liability Company
LLP	Limited License Practitioner
LMRP	Local Medical Review Policy
LOA	Leave of Absence
LOB	Line of Business
LOE	Level of Effort
LOS	Length of Stay
LPN	Licensed Practical Nurse
LTCH	Long Term Care Hospital
LTR	Lifetime Reserve Days
LTT	Local Transition Team
LVAD	Left Ventricular Assist Devices
LVN	Licensed Vocational Nurse
Back to Top
MA	Medicare Advantage
MACs	Medicare Administrative Contractors
MAI	MUE Adjudication Indicator
MAR	Medication Administration Record
MAT	Medication-Assisted Treatment
MBAS	Medicare Beneficiary Accounting System
MBI	Medicare Beneficiary Identifier
MBN	Medicare Benefit Notice
MBR	Master Beneficiary Record
MCCD	Medicare Coordinated Care Demonstration
MCD	Medicaid
MCE	Medicare Code Editor
MCM	Medicare Carriers Manual
MCO	Managed Care Organization
MCP	Monthly Capitation Payment
MCPS	Medicare Claims Processing System
MCR	Medicare Cost Report
McRef	Medicare Cost Report e-Filing
MCS	Multi Carrier System (Shared System, Medicare Part B)
MD	Medical Doctor
MDARS	Medicare Data Analysis Reporting System
MDM	Medical Decision Making
MDPP	Medicare Diabetes Prevention Program
MDS	Minimum Data Set
MECS	Microelectronic Claim Processing System (H.A.S. PC System)
MedPAC	Medicare Payment Advisory Commission
MedPARD	Medicare Participating Physicians/Suppliers Directory
MEI	Medicare Economic Index
MFA	Multi-Factor Authentication
MFAIC	Medicare Fraud and Abuse Information Coordinator
MFCU	Medicaid Fraud Control Unit
MFIS	Medicare Fraud Information Specialist
MFSDB	Medicare Physician Fee Schedule Database
MG	Milligrams
MGMA	Medical Group Management Association
MIA	Medicare Inpatient Adjudication
MICR	Medicare Internal Check Number
MIM	Medicare Intermediary Manual
MIP	Medicare Integrity Program
ML	Milliliter
MLN	Medicare Learning Network
MMA	Medicare Modernization Act of 2003
MME	Morphine Milligram Equivalent
MML	Medicare-Medicaid Library
MMORP	Medicare Management and Operations Review Program
MMS	Metropolitan Medicare System
MN	Medical Necessity
MO	Model Office
MOA	Medicare Outpatient Adjudication
MOE	Method of Evaluation
MOON	Medicare Outpatient Observation Notice
MORSF	Medicare Outpatient Rehabilitative Services Form
MOU	Memorandum of Understanding
MPFS	Medicare Physician Fee Schedule
MPFSDB	Medicare Physician Fee Schedule Data Base
MPIER	Medicare Physician Identification Eligibility Record
MPIES	Medicare Physician Identification Eligibility System
MPPR	Multiple Procedure Payment Reduction
MQSA	Mammography Quality Standards Act
MR	Medical Review
MRU	Medical Review Unit
MSA	Metropolitan Statistical Areas
MSMA	Mississippi State Medical Association
MSN	Medicare Summary Notice
MSP	Medicare Secondary Payer
MTD	Month-to-Date
MTS	Medicare Transaction System
MUA	Medically Underserved Area
MUBC	Medicare Uniform Billing Claim Entry
MUBI	Medicare Uniform Billing Inquiry
MUBS	Medicare Uniform Billing Same Day Correction
MUE	Medically Unlikely Edits
MVPS	Medicare Volume Performance Standard
MVS	Multiple Virtual System
MVS/ESA	Multiple Virtual System/Enterprise Systems Architecture
Back to Top
NA	Non-assigned (claim)
NAIC	National Association of Insurance Commissioners
NBA	Notice of Budget Approval
NCCI	National Correct Coding Initiative
NCD	National Coverage Determination
NDC	National Drug Codes
NDM	Network Data Mover
NGFR	Non-Government Furnished Resources
NJACCHO	New Jersey Association of County and City Health Officials
NHLBI	"National Heart, Lung and Blood Institute"
NIF	Not in File
NIT	Network Information and Technology
NMFA	National Medicare Fraud Alert
NOBA	Notice of Budget Approval
NOC	Not Otherwise Classified
NOMCI	Notice of Medigap Claim Information
NON-PAR	Non-participating Provider
NOOH	Notice of an Opportunity for a Hearing
NOS	Not Otherwise Specified
NOS	Number of Services
NOS	National Operating Services (GTE)
NOU	Notice of Utilization
NP	Nurse Practitioner
NPI	National Provider Identifier
NPP	Non-Physician Practitioner
NPR	Notice of Program Reimbursement
NPRM or NPR	Notice of Proposed Rulemaking
NRP	Network Resource Planning
NSEMC	National Standard Electronic Media Claims
NSF	National Standard Format
NSS	National Systems Support
NUBC	National Uniform Billing Committee
Back to Top
OA	Office Approver
OAS	Office of Audit Services
OBA	Office Backup Approver
OBI	Office of Benefits Integrity
OBRA	Omnibus Budget Reconciliation Act
OC	Occurrence Code
OC&EP	Office of Coverage and Eligibility Policy
OCE	Outpatient Code Editor
OCFAA	Office of Civil Fraud and Administrative Adjudication
OCIG	Office of Counsel to the Inspector General
OCR	Optical Claim Recognition
OD	Doctors of Optometry
OEI	Office of Evaluation & Inspection
OFO	Office of Financial Operations
OHTA	Office of Health Technology Assessment
OI	Office of Investigations
OIFO	Office of Investigations Field Services
OIG	Office of Inspector General
OIRM	Office of Information Research Management
OIS-PUF	" (HCFA's) Office of Information Services, Public Use Files "
OMB	Office of Management and Budget; also see EOMB
OMB or EOMB	Executive Office of Management and Budget
OOP	Object Oriented Programming
OP	Outpatient
OPA	Office of Program Administration
OPD PPS	Outpatient Department Prospective Payment System
OPO	Organ Procurement Organization
OPOP	Office of Program Operations Procedures
OPPS	Outpatient Prospective Payment System
OPPT or OPT	Outpatient Physical Therapy Provider
OPS	Office of Program Systems
OQCP	Office of Quality Control Programs
ORA	Omnibus Reconciliation Act of 1980
ORD	Office of Research and Development
ORF	Outpatient Rehabilitation Facility
ORM	Ongoing Responsibility of Medicals
ORT	Operation Restore Trust
OSA/OOSA	Out of Service Area
OSC	Occurrence Span Code
OSF	Open Software Foundation
OSI	Open System Interconnection
OT	Occupational Therapy/Therapist
OTAF	Obligated To Accept as Payment in Full
OTH	Other
OUD	Opioid Use Disorder
Back to Top
P&O	Prosthetics and Orthotics
PA	Physician Assistant
PAG	Performance Advisory Group
PAHHA	Pennsylvania Association of Home Health Agencies
PAMAP	Pennsylvania Medicare Advocacy Program
PAMS	Pennsylvania Association of Medical Suppliers
PAPE	Post-Admission Physician Evaluation
PAR	Participating Provider
PAR	Problem Assistance Request
PAR	Project Assistance Request
PARF	Pennsylvania Association of Rehabilitation Facilities
PART Changes	Pain, Asymmetry/Misalignment, ROM, Tissue/Tone
PAS	Preadmission Screening
PBD	Provider-Based Departments
PBP	Provider Based Physician
PBS	Pennsylvania Blue Shield
PC	Personal Computer
PC	Professional Component
PCP	Primary Care Physician
PDF	Portable Document Format
PDL	Program Design Language
PDM	Personalized Documentation Manager
PDM	Parallel Development Manager
PDR	Physician Desk Reference
PDS	Partitioned Data Sets
PDT	Purchased Diagnostic Test
PEB	Program Evaluation Branch
PEBTAG	Provider Electronic Billing Technical Advisory Group
PECOS	Provider Enrollment, Chain and Ownership System
PEI	Production Environment Interface
PEL	Pennsylvania Economy League
PEN	Parenteral / Enteral Nutrition
PENS	Percutaneous Electrical Nerve Stimulation
PEPPER	Program for Evaluating Payment Patterns Electronic Report
PET	(Scans) Positron Emissions Tomography
PFSH	Past Medical, Family and Social History
PHI	Protected Health Information
PHO	Physician Hospital Organization
PHP	Partial Hospitalization Program
PHS	Public Health Service
PI	Program Integrity
PID	Provider Identification Department
PII	Personally Identifiable Information
PIM	Program Integrity Manual
PIMR	Program Integrity Management Reporting System
PIN	Provider Identification Number
PIP	Periodic Interim Payment
PM	Program Management
PMA	Pre-Marlset Approval
PMCF	Pennsylvania Medical Care Foundation
PMCS	Program Management Control System
PMP	Project Management Plan
PMRB	Provider Medical Review Board
PMTT	Programmable Magnetic Tape Terminal
PO	By Mouth
POA	Power of Attorney
POA	Present of Admission
POA	Provider Office Approver
POBA	Provider Office Backup Approver
POC	Plan of Care
POPT	Provider Overpayment Prevention Initiative
POR	Provider Overpayment Report
POS	Point of Service
POSIX	Portable Operating System Interface Exchange
PPC	Payment Processing Cycle
PPO	Preferred Provider Organization
PPP	Preferred Provider Program
PPR	Physician Payment Reform
PPS	Prospective Payment System
PQRI	Physician Quality Reporting Initiative
PR	Professional Relations Department
PRIMOS	Prime Operating System
PRISM	Project to Redesign Information Systems Management
PRM	Provider Reimbursement Manual
PRO	Peer Review Organization
PRO/West	Peer Review Organization West
ProPAC	Prospective Payment Assessment Commission
PRRB	Provider Reimbursement Review Board
PRS	PRO Review System
PS&E	Performance Standards and Evaluation
PS&R	Provider Statistical and Reimbursement Report
PSC	Patient Status Code
PSC	Provider Service Center
PSO	Provider-Sponsored Organization
PSOR	Physician/Supplier Overpayment Report
PSRO	Professional Standards Review Organization
PSYCH	Psychiatric Services
PT	Physical Therapy/Therapist
PTAN	Provider Transaction Access Number
PTC	Primary Transaction Code
PTO	Pay to Organization
PTP	Procedure to Procedure
PUC	Public Utilities Commission
PW	Project Workbench
PWK	Paperwork
PXRS	Portable X-Ray Supplier
Back to Top
QA	Quality Assurance
QAP	Quality Assurance Program
QC	Quality Control
QI	Qualifying Individual
QIC	Qualified Independent Contractors
QIO	Quality Improvement Organization
QMB	Qualified Medicare Beneficiaries
QMS	Quality Management System
RA	Remittance Advice
RA	Recovery Auditor
RAC	Recovery Audit Contractor
RACF	Resource Access Control Facility
RARC	Remittance Advice Remark Codes
RBRVS	Resource-Base Relative Value Scale
RBRVU	Resource-Base Relative Value Unit
RBS	Report of Benefit Saving
RC	Reasonable Charge
RCICS	Registry Customer Information Control System
RDES	Regional Data Exchange System
REMIT	Remittance Notice
REP PAYEE	Representative Payee
RET	Retired
RFA	Restricted Medicare Fraud Alert
RGT	Requirements Gathering Techniques
RHC	Rural Health Clinic
RHHI	Regional Home Health Intermediaries
RIC	Record Identification Code
RMAPS	Rocky Mountain Part A Processing System
RMF	Resource Measurement Facility
RMFA	Regional Medicare Fraud Alert
RMP	Resource Management Plan
RMU	Resource Management Unit
RN	Registered Nurse
RNHCI	Religious Nonmedical Health Care Institutions
RO	Regional Office
ROE	Report of Eligibility
ROM	Range of Motion
ROM	Read Only Memory
ROS	Review of Systems
RPC	Remote Procedure Call
RPCH	Rural Primary Care Hospital
RPT	Registered Physical Therapist
RRB	Railroad Retirement Board
RRC	Rural Referral Centers
RRE	Responsible Reporting Entity
RTI	Return to Intermediary
RTP	Return to Provider
RUG	Resource Utilization Group
RVU	Relative Value Unit
Back to Top
S/W	Software
SADBUS	Small Disadvantaged Business
SAMHSA	Substance Abuse and Mental Health Services Administration
SBR	Supplemental Budget Request
SC	Subcutaneously
SCLM	Source Code Librarian Manager
SCN	Strategic Communication Network
SDA	System Design Alternative
SDLC	Systems Development Life Cycle
SDPS	Standard Data Processing System (PRO)
SDWS	Systems Development Methodology/Structured
SE	Special Edition
SES	System External Specifications
SGS	SafeGuard Services LLC
SGR	Sustainable Growth Rate
SHIP	State Health Insurance Assistance Program
SIIS	Supplemental Insurance Interface System
SIS	System Internal Specifications
SLF	Self
SLIM	Software Life Cycle Maintenance
SLMB	Specified Lower Income Medicare Beneficiary
SLP	Speech Language Pathology
SMF	System Measurement Facility
SMI	Supplementary Medical Insurance
SMRC	Supplemental Medical Review Contractor
SMS	System Managed Storage
SNF	Skilled Nursing Facility
SOI	Statement of Intent
SOS	Site of Service
SOW	Statement of Work
SPARCS	Statewide Planning and Research Cooperative System
SPEC	Provider Specialty
SPIN	Supplier Profile Identification Number
SPR	Standard Paper Remittance
SQL	System Query Language
SRA	Systems Research and Application Corporation (PRO)
SSA	Social Security Administration
SSB	Standard Systems Branch (CMS)
SSC	Shared Service Center
SSN	Social Security Number
SSOE	Statistical Sampling for Overpayment Estimation
STAR	System Tracking for Audit and Reimbursement
STC	Secondary Transaction Code
STI	Sexually Transmitted Infections
SUBC	State Uniform Billing Committee
SUR	State Utilization Review Unit
Back to Top
TAG	Technical Advisory Group
TAHFA	Texas Association of Healthcare Financial Administration
TAN	Treatment Authorization Number
TAR	Telephone Assistance Request
TAT	Turn-Around-Time
TC	Technical Component
TCM	Transitional Care Management
TCU	Transitional Care Unit
TEFRA	Tax Equity and Fiscal Responsibility Act of 1983
TENS	Transcutaneous Electrical Nerve Stimulation
TIN	Taxpayer Identification Number
TMC	Technology Management Corporation
TMCS	Time Management Collection System (GTE)
TMJ	Temporomandibular Joint Dysfunction
TNIF	"True, Not in File"
TOB	Type of Bill
TOPs	Transitional Outpatient Payments
TOR	Terminal Owning Region
TOS	Type of Service
TP	Treatment Plan
TPE	Targeted Probe and Educate
TPN	Total Parenteral Nutrition
TPNS	TeleProcessing Network Simulator
TQM	Total Quality Management
TS	Technical Support Department
TSO/ISPF	TSO Interactive System Productivity Facility
Back to Top
UARS	Undocumented Alien Reimbursement System
UB-04	Universal Billing Form 04
UB-82	Uniform Bill - HCFA-1450 Billing Form
UB-92	Uniform Bill - HCFA-1450 Billing Form
UCR	"Usual, Customary and Reasonable"
UM	Utilization Management
UMS	Universal Measured Service
UOS	Units of Service
UPIC	Unified Program Integrity Contractor
UPIN	Uniform Physician Identification Number
UPS	Uninterruptable Power Supply
UR	Utilization Review
URC	Utilization Review Committee
USPSTF	U.S. Preventive Services Task Force
UTR	Ultra High Therapy RUG
Back to Top
VA	Veterans Administration
VAN	Value Added Networks
VC	Value Code
VDP	Voluntary Disclosure Pilot
VDT	Video Display Terminal
VIPS	Viable Information Processing Systems
VM/ESA	Virtual Machine/Enterprise Systems Architecture
VOS	Virtual Operating System
VSAM	Virtual Storage Access Method
VTAM	Virtual Telecommunications Access Method
WBS	Work Breakdown Structure
WC	Workers Compensation
WCMSA	Workers' Compensation Medicare Set Aside
WEDI	Workgroup for Electronic Data Interchange
WIP	Work in Progress
WPC	Washington Publishing Company
WPS	Wisconsin Physicians Service
YTD	Year-to-Date
ZPIC	Zone Program Integrity Contractor

Was this page helpful?

Last modified: 08/12/2024

Person(s) with Medicare