Outpatient Prospective Payment Systems (OPPS)
CMS generally makes payment for hospital outpatient department services through the Hospital Outpatient Prospective Payment System (OPPS).
Comparison of Proposed 2025 OPPS Addendum B With July 2024 Addendum B.
Congress is considering legislation that would change current billing practices for Medicare and the commercial insurance market to require each off-campus hospital outpatient department (HOPD) to be assigned a unique NPI as a condition of payment.
The Centers for Medicare & Medicaid Services (CMS) July 10 released its calendar year (CY) 2025 outpatient prospective payment system (OPPS) and ambulatory surgical center (ASC) proposed rule. The rule would increase OPPS rates by a net 2.6% in CY 2025 compared to CY 2024. CMS…
The Centers for Medicare & Medicaid Services July 10 issued a proposed rule that would increase Medicare hospital outpatient prospective payment system rates by a net 2.6% in calendar year 2025 compared to 2024. This includes a proposed 3.0% market basket update, offset by a 0.4 percentage…
CMS has yet again proposed an inadequate update to hospital payments. This proposed increase for outpatient hospital services of only 2.6% comes despite the fact that many hospitals across the country continue to operate on negative or very thin margins that make providing care and investing in…
As urged by the AHA, the Centers for Medicare & Medicaid Services Feb. 6 corrected an error in the outpatient prospective payment system final rule for calendar year 2024 that reduced by over 40% reimbursement for hyperbaric oxygen therapy, a critical treatment option in advanced wound care.
AHA shares comments and ask that commissioners consider the following issues before making their final payment update recommendations at the upcoming Medicare Payment Advisory Commission (MedPAC) meeting.
The Centers for Medicare & Medicaid Services last week corrected a technical error in the displayed calendar year 2024 outpatient prospective payment system payment rate for APC 5061 (Hyperbaric Oxygen Therapy).
AHA Dec. 6 expressed concern that the outpatient prospective payment system final rule for calendar year 2024 contains an error that reduces reimbursement for hyperbaric oxygen therapy by over 40%, and urged the Centers for Medicare & Medicaid Services to issue a correction establishing an…
Discover how the ºÚÁÏÕýÄÜÁ¿ Association (AHA) is advocating for fair hyperbaric oxygen therapy cost reimbursement rates in CMS' OPPS CY 2024 Final Rule.