1. Dollar amount to be paid to a provider for medical services given to a member of a managed care plan. 2. Total payment that a hospital or community mental health center gets when it provides outpatient services to Medicare patients. Also see average payment rate (APR).

Activities to prevent and recover inappropriate Medicare benefit payments including Medicare Secondary Payer (MSP), medical review/utilization review (MR/UR), provider audits, and fraud and abuse detection.

Payment system in which an insurance premium is deducted by the employer from the employee’s earnings and sent to the insurance company.

Taxes deducted from gross wages and salaries such as those for Social Security (Federal Insurance Contributions Act [FICA]) and unemployment insurance. Also called contributions and taxes.

Abbreviation that means primary care case management. See primary case management (PCM).

Abbreviation for primary care provider, primary care physician, or primary care practitioner (PCP). See primary care physician (PCP).

Abbreviation that means prescription medication coverage (PCS), personal communication system (PCS), and physician coding specialist (PCS).