Outpatient Prospective Payment Systems (OPPS)
CMS generally makes payment for hospital outpatient department services through the Hospital Outpatient Prospective Payment System (OPPS).
A federal judge yesterday ruled in favor of the AHA and hospital organizations saying that the Centers for Medicare & Medicaid Services exceeded its statutory authority when it reduced payments for hospital outpatient services provided in off-campus provider-based departments grandfathered…
A federal judge today ruled in favor of the AHA and hospital organizations saying that the Centers for Medicare & Medicaid Services exceeded its statutory authority when it reduced payments for hospital outpatient services provided in off-campus provider-based departments grandfathered under…
The AHA appreciates the opportunity to comment on the Centers for Medicare & Medicaid Services’ specialty care models proposed rule, and specifically on the radiation oncology (RO) model. As described in the proposed rule, the RO model would test whether prospective, bundled payments for 90-day…
Held August 29, 2019
Regulatory Advisory
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Presentation Slides PDF
With Congress back in town and a full slate of health care issues on its agenda, AHA President and CEO Rick Pollack, Executive Vice President Tom Nickels and Senior Associate Director of Federal Relations Priscilla Ross hosted a special AHA Town Hall webcast live from the AHA’s Advocacy Day in…
The Centers for Medicare & Medicaid Services July 29 issued its calendar year 2020 outpatient prospective payment system/ambulatory surgical center proposed rule.
Comparison of Proposed 2020 OPPS Addendum A with July 2019 Addendum A
Comparison of Proposed 2020 OPPS Addendum B with July 2019 Addendum B
Spreadsheet comparisons at the HCPCS level, using proposed rule Addendum B compared to Addendum B effective July 2019.
Spreadsheet comparing relative weights and payment rates at the APC level, using the 2020 proposed rule Addendum A compared to Addendum A effective July 1, 2019.