CY2017 Medicare OPPS Final Rule Analysis now available

The CY 2017 Medicare Outpatient Prospective Payment System (OPPS) final rule analysis is intended to show members how Medicare outpatient fee-for-service payments will change from CY 2016 to CY 2017 based on the policies adopted in the CY 2017 OPPS final rule. The SDAHO brief is available here.

The final rule includes policies that will:

  • Implement 28 new Comprehensive Ambulatory Payment Classifications (C-APCs) that bundle all payments for certain device-dependent procedures
  • Remove the “Pain Management” dimension from the FFY 2018 Hospital Value-Based Purchasing (VBP) program
  • Establish guidelines for payment to off-campus sites of a hospital providing outpatient services
  • Expand the list of services to be packaged into APCs as opposed to separately paid
  • Update payment rates and policies for Ambulatory Surgical Centers (ASCs)

Comments related to this final rule with comment period are due to CMS by December 31 and can be submitted electronically here by using the website’s search feature to search for file code “1656-FC”. Comments are to be limited to the following:

  • The payment classifications assigned to new Level II HCPCS codes and recognition of new and revised Category I and III CPT codes
  • The 20-hour a week minimum requirement for partial hospitalization services
  • The potential limitation on clinical service line expansion or volume of services by nonexempt off-campus provider-based departments (PBDs)
  • The Medicare Physician Fee Schedule (MPFS) payment rates for nonexempt items and services furnished and billed by nonexempt off-campus PBDs of hospitals