Outpatient Prospective Payment Systems (OPPS)
CMS generally makes payment for hospital outpatient department services through the Hospital Outpatient Prospective Payment System (OPPS).
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…
President Trump today submitted to Congress his budget request for fiscal year 2021.
The Centers for Medicare & Medicaid Services has identified the Healthcare Common Procedure Coding System billing codes for hospital outpatient services that will require prior authorization starting July 1 under the hospital outpatient prospective payment system final rule for calendar year…
HPA spreadsheets for relative weights and payment rates for the hospital outpatient prospective payment system (OPPS) comparing 2020 to 2019 rates. There are two spreadsheets, one based on APC-level comparisons and the other on HCPCS-level comparisons.
The Medicare Payment Advisory Commission (MedPAC, or the Commission) will vote this month on payment recommendations for 2021. The American Hospital Association (AHA) asks that commissioners consider the following issues that would have a significant impact on hospitals, health systems, other…
The AHA, joined by Association of American Medical Colleges and several member hospitals, today filed a lawsuit against the Department of Health and Human Services for continuing to reduce in calendar year 2020 payments for hospital outpatient services provided in off-campus provider-based…