Outpatient Prospective Payment Systems (OPPS)

CMS generally makes payment for hospital outpatient department services through the Hospital Outpatient Prospective Payment System (OPPS).

QUESTION PRESENTED: Whether Chevron deference applies to a statutory interpretation question that determines both the lawfulness of agency action and the court’s jurisdiction.
The Centers for Medicare & Medicaid Services (CMS) yesterday announced that, as a result of a July 17, 2020 U.S. Court of Appeals ruling in its favor, it will begin reprocessing claims for outpatient clinic visits furnished in calendar year (CY) 2019 from excepted off-campus provider-based…
Starting by July 1, the Centers for Medicare & Medicaid Services will reprocess calendar year 2019 claims for hospital outpatient clinic visit services provided in off-campus provider-based departments excepted under the Bipartisan Budget Act of 2015 to pay them at 70% of the outpatient…
The Centers for Medicare & Medicaid Services Dec. 2 issued its calendar year (CY) 2021 outpatient prospective payment system (OPPS)/ambulatory surgical center (ASC) final rule. In addition to standard updates, the rule maintains previous payment cuts for certain drugs purchased under the 340B…
At A Glance The Centers for Medicare & Medicaid Services (CMS) yesterday released the calendar year (CY) 2021 outpatient prospective payment system (OPPS)/ambulatory surgical center (ASC) final rule.
AHA comments on the Centers for Medicare & Medicaid Services’ hospital outpatient prospective payment system and ambulatory surgical center payment system proposed rule for calendar year 2020.
This advisory provides details of the Centers for Medicare & Medicaid Services’ calendar year 2021 outpatient prospective payment system/ambulatory surgical center proposed rule.
Attached are three spreadsheets, one comparing relative weights and payment rates at the APC level, using the 2021 proposed rule Addendum A compared to Addendum A effective July 1, 2020, as downloaded from the CMS website. The second spreadsheet makes similar comparisons at the HCPCS level, using…
The Centers for Medicare & Medicaid Services (CMS) today released the calendar year (CY) 2021 outpatient prospective payment system (OPPS)/ambulatory surgical center (ASC) proposed rule.