CMS Releases the Proposed Rule for the 2017 Hospital Outpatient Prospective Payment System

On July 1, 2016, the Centers for Medicare and Medicaid Services (CMS) released its proposed rule with 60-day comment period for changes to the calendar year (CY) 2017 hospital outpatient prospective payment system (HOPPS). In this rule, CMS proposes site-neutral payments, further restructures the imaging ambulatory payment classifications (APCs), expands its use of comprehensive APCs (C-APCs) and proposes a new modifier for reduction in film-based X-ray services. CMS is proposing to make site neutral payments to new off-campus sites that provide items and services to outpatients based on the Medicare Physician Fee Schedule technical component rate and would deny their eligibility for payment under HOPPS. This policy would begin January 1, 2017, and is a transitional policy that would only be applicable for one year. This proposal stems from Section 603 of the Bipartisan Budget Act of 2015 (Pub. L. 114-74), which requires that certain items and services furnished by certain off-campus sites shall not be considered covered outpatient department services for purposes of OPPS payment and shall instead be paid “under the applicable payment system” beginning January 1, 2017. CMS makes several proposals related to which off-campus providers and which items and services are “excepted” from application of payment changes under this provision. CMS continues their restructuring of their ambulatory payment classifications (APCs). In this proposed rule, CMS ...
Source: American College of Radiology - Category: Radiology Source Type: news