Outpatient Prospective Payment Systems (OPPS)
CMS generally makes payment for hospital outpatient department services through the Hospital Outpatient Prospective Payment System (OPPS).
On July 6, CMS released the calendar year (CY) 2017 outpatient prospective payment system (OPPS)/ambulatory surgical center (ASC) proposed rule. In addition to standard updates to the OPPS and ASC payment systems, the rule proposes to implement the site-neutral provisions of Section 603 of the…
Hospitals and health systems and more than half of the House and the Senate requested that CMS provide reasonable flexibility when implementing Section 603 of the Bipartisan Budget Act of 2015 in order to ensure that patients have continued access to hospital care.
America’s hospitals appreciate the leadership of Chairman Brady and Representatives Tiberi and McDermott on behalf of the hospital community. We agree with their policy that the readmissions program needs to be adjusted to account for socioeconomic status.
Only a few days remain to gather signatures for bipartisan "Dear Colleague" letters circulating in the Senate and House urging the Centers for Medicare & Medicaid Services to be flexible in implementing changes affecting off-campus hospital outpatient departments this summer.
Bipartisan Senate letter asks CMS for flexibility in implementing site-neutral HOPD changes
Bipartisan House letter asks CMS for flexibility in implementing site-neutral HOPD changes
AHA recommendations regarding CMS' upcoming rulemaking for Section 603 of the Bipartisan Budget Act of 2015.
Outpatient PPS – Calendar Year 2022 Rules:
2022 Calendar Year Proposed Rule:
HPA Spreadsheet Comparisons and Lookup Tool | AHA Statement
The AHA expressed disappointment over the Centers for Medicare & Medicaid Services’ (CMS) decision to reduce hospital outpatient payment rates by 0.4% next year in its final rule for the outpatient prospective payment and ambulatory surgical center payment systems (PPS). However, in the final…