Additionally, the OPPS
final rule provides relief to rural hospitals and rural clinicians.
Following the 2014 OPPS
Final Rule, CMS posted Transmittal R2845CP on December 27, 2014, to offer further instructions on changes to the OPPS
We examine whether the outpatient reimbursement cuts triggered by OPPS
led hospitals to shift Medicare services from the outpatient setting into the inpatient setting.
In 2007, the OPPS
cap reduced the fee for the performance of about one in four physician imaging tests overall, and fees for advanced tests were more likely than other imaging tests to be paid at the OPPS
Unlike Medicare's OPPS
with 820 ambulatory payment classes (APCs), over 2,450 HCFA Common Procedure Coding System (HCPCS) codes are uniquely assigned to 1 of just 9 ASC payment classes.
Combining published regulations, program transmittals and local medical review policies, which change monthly, OPPS
requires the industry to absorb more than 50 different updates throughout the year to maintain regulatory compliance.
Instead, BIO believes that orphan products with fewer than 30,000 OPPS
claims should be reimbursed at hospital invoice costs and that those with over 30,000 claims should also be reimbursed at invoice if the prescriptions are made to treat the orphan indication.
CMS is finalizing policies to implement section 603 of the Bipartisan Budget Act of 2015, which requires that certain items and services furnished by certain off-campus hospital outpatient departments will no longer be paid under the OPPS
beginning January 1, 2017.
HSS builds and updates APC Assistant by taking apart the OPPS
, the APC system and the OCE-studying volumes of published documentation, exploring numerous live data situations and organizing the knowledge to assist a hospital's revenue team.
list is part of a new outpatient program being implemented by HCFA.
But the annual OPPS
payment inflation update will be reduced by 2.
CMS is finalizing a number of OPPS
and ASC policies that will improve the quality of care Medicare patients receive.