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.
AHA News
- Jan 03, 2012 | CMS makes correction to OPPS, ASC rule
- Nov 01, 2011 | CMS releases final 2012 OPPS and ESRD rules
- Nov 02, 2010 | CMS releases final 2011 OPPS, ASC, PFS, HH rules
- Aug 31, 2010 | AHA urges changes to OPPS/ASC proposed rule
- Nov 02, 2009 | CMS releases OPPS and ASC final rule
- Aug 28, 2009 | OPPS, physician fee comment re-submittals due Monday
- Aug 26, 2009 | AHA recommends changes to proposed OPPS, ASC rule
- Aug 24, 2009 | Software glitch affects some OPPS, physician fee comments
- May 08, 2009 | DoD increases TRICARE OPPS adjustment for eligible hospitals
- Mar 05, 2009 | AHA urges DoD to revise TRICARE OPPS final rule
Publications
Recent Efforts
- Dec 13, 2011 | Medicare Outpatient PPS and ASC Final Rule for CY 2012
- Dec 09, 2011 | Urge Congress Not to Cut Hospital Payments Including Billions from Hospital Outpatient Payments and Bad Debt - <em>House slated to vote on package Tuesday </em>
- Dec 07, 2011 | Urge Congress Not to Cut Hospital Payments Including Billions from Hospital Outpatient Payments - <em>Coming Days Crucial</em>
- Nov 11, 2011 | Wage Index Report, November 2011
- Nov 02, 2011 | CMS Releases Three Final Rules For CY 2012 - Hospital Outpatient/ASC Payment System, Physician Fee Schedule and End-Stage Renal Disease PPS
- Nov 01, 2011 | Statement on Inpatient VBP Provisions in Final Outpatient Prospective Payment Rule
- Oct 03, 2011 | Health Organizations to the Joint Select Committee on Deficit Reduction Re: GME
- Aug 29, 2011 | AHA's comments on the hospital VBP portion of the CMS' Hospital OPPS Propsed Rule CY 2012
- Aug 29, 2011 | AHA Comments to CMS Re: CMS' Calendar Year 2012 Hospital Outpatient Prospective Payment System
- Jul 21, 2011 | Medicare Outpatient PPS and ASCL Proposed Rule for CY 2012
