Outpatient Prospective Payment Systems (OPPS)

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

Starting by July 1, the Centers for Medicare & Medicaid Services will reprocess calendar year 2019 claims for hospital outpatient clinic visit services provided in off-campus provider-based departments excepted under the Bipartisan Budget Act of 2015 to pay them at 70% of the outpatient…
The Centers for Medicare & Medicaid Services Dec. 2 issued its calendar year (CY) 2021 outpatient prospective payment system (OPPS)/ambulatory surgical center (ASC) final rule. In addition to standard updates, the rule maintains previous payment cuts for certain drugs purchased under the 340B…
At A Glance The Centers for Medicare & Medicaid Services (CMS) yesterday released the calendar year (CY) 2021 outpatient prospective payment system (OPPS)/ambulatory surgical center (ASC) final rule.
AHA comments on the Centers for Medicare & Medicaid Services’ hospital outpatient prospective payment system and ambulatory surgical center payment system proposed rule for calendar year 2020.
This advisory provides details of the Centers for Medicare & Medicaid Services’ calendar year 2021 outpatient prospective payment system/ambulatory surgical center proposed rule.
Attached are three spreadsheets, one comparing relative weights and payment rates at the APC level, using the 2021 proposed rule Addendum A compared to Addendum A effective July 1, 2020, as downloaded from the CMS website. The second spreadsheet makes similar comparisons at the HCPCS level, using…
The Centers for Medicare & Medicaid Services (CMS) today released the calendar year (CY) 2021 outpatient prospective payment system (OPPS)/ambulatory surgical center (ASC) proposed rule.
The AHA, joined by the Association of American Medical Colleges and a number of member hospitals, filed a brief urging the U.S. Court of Appeals for the District of Columbia Circuit to affirm a district court ruling that voided the Centers for Medicare & Medicaid Services’ calendar year 2019…
The U.S. Court of Appeals for the D.C. Circuit will hear oral arguments April 17 in the Department of Health and Human Services’ appeal of a district court ruling in favor of the AHA and hospital organizations that found the agency could not reduce calendar year 2019 payments for hospital…