Outpatient Prospective Payment Systems (OPPS)
CMS generally makes payment for hospital outpatient department services through the Hospital Outpatient Prospective Payment System (OPPS).
AHA policy staff hosted a webinar to review updates to the CMS Hospital Price Transparency GitHub following the recent changes to the requirements in the OPPS final rule. Presented by Terri Postma, principal at Health Policy Alternatives. Members can view the recording of the session.
Several health care groups, including the AHA, Jan. 12 told the Centers for Medicare & Medicaid Services it is wrong to tell hospitals and health systems they “are to” complete the agency’s Outpatient Prospective Payment System Drug Acquisition Cost Survey and urged CMS to correct an FAQ issued…
Several health care groups, including the AHA, today told the Centers for Medicare & Medicaid Services it is wrong to tell hospitals and health systems they “are to” complete the agency’s Outpatient Prospective Payment System Drug Acquisition Cost Survey and urged CMS to correct an FAQ issued…
This webinar reviews the latest changes to the Hospital Price Transparency requirements, which were finalized in the CY2026 OPPS Rule. These changes go into effect on January 1, 2026. However, CMS will delay enforcement until April 1, 2026. The webinar features Terri Postma, a principal at HPA and…
This webinar reviews key provisions proposed in the Outpatient, Ambulatory Surgical Center Final Rule for CY 2026. Some of the topics discussed include OPPS payment update and area wage index, Payment policies for drugs, biologicals and radiopharmaceuticals, Site-neutral payments, Behavioral health…
The Centers for Medicare & Medicaid Services Nov. 21 released its calendar year 2026 outpatient prospective payment system and ambulatory surgical center final rule. The rule increases OPPS rates by a net 2.6% in CY 2026 compared to CY 2025.
The AHA is disappointed that CMS has finalized cuts to hospital and health system services, including those in rural and underserved communities. Combined with its continued inadequate market basket updates, the agency is exacerbating the challenging financial pressures under which hospitals are…
The Centers for Medicare & Medicaid Services Nov. 21 issued a final rule that, among other provisions, increases Medicare hospital outpatient prospective payment system rates by a net 2.6% in calendar year 2026 compared to 2025.
The Centers for Medicare & Medicaid Services (CMS) Oct. 31 issued a final rule that updates physician fee schedule (PFS) payments for calendar year (CY) 2026.
The AHA commented Sept. 15 on the Centers for Medicare & Medicaid Services calendar year 2026 outpatient prospective payment system and ambulatory surgical center payment system proposed rule.