In Billing
Nov 2nd, 2017
Hospital outpatient departments (HOPD) and ambulatory surgical centers (ASC) will see a small payment rate increase in 2018, provided quality reporting requirements are met. The Centers for Medicare & Medicaid Services (CMS) published, Nov. 1, a final rule for Outpatient Prospective Payment System (OPPS) and ASC Payment System (ASC PS) payment policies and rates that go ...
This year sees expanded packaging, encounter-based payments, and off-campus provider-based department changes. By Denise Williams, RN, COC As in past years, the Centers for Medicare & Medicaid Services (CMS) based 2017 Hospital Outpatient Prospective Payment System (OPPS) payments on claims data submitted by hospital providers. This year, that resulted in a 1.65 percent update. Hospitals ...
Aug 31st, 2016
The October 2016 update to the Outpatient Prospective Payment System (OPPS) includes one new HCPCS Level II code, two deleted HCPCS Level II codes; ambulatory payment classification (APC) and status indicator (SI) changes to several drug codes; and other changes to various payment policies. New Ultrasound Code HCPCS Level II code C9744 Ultrasound, abdominal, with ...
Properly adjusted APC payment depends on correct HCPCS Level II codes and credited charges. The Centers for Medicare & Medicaid Services (CMS) pays for hospital outpatient procedures on a rate-per-service basis that varies according to the assigned ambulatory payment classification (APC). Hospitals are required to account for credits received from the manufacturer and medical devices ...
Jan 1st, 2016
New policies may affect the entire industry, not just hospitals. In the 2016 Hospital Outpatient Prospective Payment System (OPPS) final rule, the Centers for Medicare & Medicaid Services (CMS) continues to base payments on claims data submitted by hospital providers. In considering 92 million claims for calculating the payment rates, CMS finalized several policies in ...