Outpatient Prospective Payment Systems (OPPS)

CMS generally makes payment for hospital outpatient department services through the Hospital Outpatient Prospective Payment System (OPPS).

The Addendum B Spreadsheet compares relative weights and payment rates at the HCPCS level, using proposed rule Addendum B compared to 2023 Addendum B (July 1, 2023 file).
The Addendum A spreadsheet compares relative weights and payment rates at the APC level, using the 2024 proposed rule Addendum A compared to 2023 Addendum A (July 1, 2023 file), as downloaded from the CMS website.
The American Hospital Association would like to provide feedback on sections of H.R. 4822, the “Health Care Price Transparency Act of 2023,” as well as H.R. 3284, the “Providers and Payers COMPETE Act.”
The Centers for Medicare & Medicaid Services (CMS) July 13 released its calendar year (CY) 2024 outpatient prospective payment system (OPPS) and ambulatory surgical center (ASC) proposed rule. The rule would increase OPPS rates by a net 2.8% in CY 2024 compared to CY 2023. The rule also…
The AHA is concerned that CMS is proposing an outpatient hospital payment update of only 2.8% in spite of persistent financial headwinds facing the hospital field. Most hospitals across the country continue to operate on negative or very thin margins that make providing care and investing in their…
The Centers for Medicare & Medicaid Services (CMS) on Nov. 1 posted its calendar year (CY) 2023 outpatient prospective payment system (OPPS)/ambulatory surgical center (ASC) final rule. The rule increases OPPS rates by a net 3.8% in CY 2023 compared to 2022.
The Centers for Medicare & Medicaid Services (CMS) Nov. 1 posted its calendar year (CY) 2023 outpatient prospective payment system (OPPS) and ambulatory surgical center (ASC) final rule. The rule increases OPPS rates by a net 3.8% in CY 2023 compared to 2022.
AHA comments on the CMS' hospital outpatient prospective payment system and ambulatory surgical center payment system proposed rule for calendar year (CY) 2023.
Patients with complex medical and social needs are often challenging to treat in a traditional medical encounter.
The U.S. District Court for the District of Columbia should vacate the 2022 outpatient prospective payment system rule insofar as it sets a payment rate for 340B hospitals that is lower than the generally applicable payment rate of Average Sales Price plus 6%, AHA told the court yesterday.