Outpatient Prospective Payment Systems (OPPS)
CMS generally makes payment for hospital outpatient department services through the Hospital Outpatient Prospective Payment System (OPPS).
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…
The Department of Health and Human Services Dec. 12 announced that it intends to ask the U.S. Court of Appeals to reverse a district court ruling in favor of the AHA.
The AHA is pleased that at our urging, CMS will be repaying affected hospitals the full OPPS rate for 2019 to support the critical work they do for the patients and communities they serve.
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As part of its yearly process to establish Medicare rates under the Outpatient Prospective Payment System (OPPS), the U.S. Department of Health and Human Services (HHS) recently published a new rule setting those rates for the 2020 calendar year. Because the new rule effectively reduces payment…
The Centers for Medicare & Medicaid Services (CMS) Nov. 1 released the calendar year (CY) 2020 outpatient prospective payment system (OPPS)/ambulatory surgical center (ASC) payment system final rule. In addition to standard updates, the rule finishes phasing in the site-neutral rate for clinic…
The Centers for Medicare & Medicaid Services Nov. 1 released the calendar year 2020 outpatient prospective payment system/ambulatory surgical center payment system final rule.