Outpatient Prospective Payment System
Section 4523 of the Balanced Budget Act of 1997 (BBA) provides authority for CMS to implement a prospective payment system (PPS) under Medicare for hospital outpatient services, certain Part B services furnished to hospital inpatients who have no Part A coverage, and partial hospitalization services furnished by hospitals and community mental health centers. The provisions of this section were further modified by sections 201 and 202 of the Balanced Budget Refinement Act of 1999 (BBRA) and subsequent legislation.
The outpatient prospective payment system (OPPS) significantly changes how hospitals are reimbursed for outpatient services under Medicare - affecting communications, coding procedures, patient records, billing, and reimbursement. Hospitals require new strategies for the effective management of outpatient information, resources, and services.
- Oct 8, 2014 | OIG recommends changing how CAH outpatient coinsurance is calculated
- Sep 2, 2014 | AHA submits comments on proposed OPPS rule for CY 2015
- Jul 7, 2014 | CMS releases CY 2015 OPPS, ASC proposed rule
- Mar 12, 2014 | CMS advised to reduce supervision level for 18 outpatient therapeutic services
- Sep 6, 2013 | AHA urges CMS to extend direct supervision enforcement moratorium
- Nov 1, 2012 | CMS releases final CY rules for outpatient departments, physicians
- Jan 3, 2012 | CMS makes correction to OPPS, ASC rule
- Nov 1, 2011 | CMS releases final 2012 OPPS and ESRD rules
- Aug 29, 2011 | AHA comments on proposed outpatient changes for 2012
- Jan 13, 2011 | MedPAC recommends payment reduction for coding changes in 2012
- Nov 21, 2014 | Medicare Outpatient PPS and ASC Final Rule for CY 2015
- Nov 03, 2014 | CMS Releases Three Final Rules For CY 2015
- Jul 25, 2014 | Medicare Outpatient PPS and ASC Proposed Rule for CY 2015
- Jul 07, 2014 | CMS Releases Three Proposed Rules for CY 2015: Hospital Outpatient/ASC Payment System, Physician...
- Dec 19, 2013 | Medicare Outpatient PPS and ASC Final Rule for CY 2014
- Dec 02, 2013 | CMS Releases Two Final Rules For CY 2014: Hospital Outpatient/ASC Prospective Payment System And Physician Fee Schedule
- Sep 13, 2013 | AHA to CMS Re: CY 2014 OPPS Proposed Rule Provisions Affected by Corrections
- Sep 06, 2013 | AHA to CMS Re: Hospital OPP and ASC Payment Systems and Quality Reporting Programs
- Aug 02, 2013 | Medicare Outpatient PPS and ASC Proposed Rule for CY 2014
- Jul 09, 2013 | CMS Releases Three Proposed Rules for CY 2014: Hospital Outpatient/ASC Payment System, Physician Fee Schedule and End-Stage Renal Disease Payment System