Outpatient PPS

Dec 4, 2018
The AHA, jointly filed a lawsuit against the Department of Health and Human Services for finalizing a policy to phase-in a reduction in payments for hospital outpatient clinic visit services furnished in off-campus provider-based departments that are grandfathered under Section 603 of the…
Oct 5, 2020
AHA comments on the Centers for Medicare & Medicaid Services’ hospital outpatient prospective payment system and ambulatory surgical center payment system proposed rule for calendar year 2020.
Aug 20, 2020
This advisory provides details of the Centers for Medicare & Medicaid Services’ calendar year 2021 outpatient prospective payment system/ambulatory surgical center proposed rule.
Aug 13, 2020
Attached are three spreadsheets, one comparing relative weights and payment rates at the APC level, using the 2021 proposed rule Addendum A compared to Addendum A effective July 1, 2020, as downloaded from the CMS website. The second spreadsheet makes similar comparisons at the HCPCS level, using…
Aug 4, 2020
The Centers for Medicare & Medicaid Services (CMS) today released the calendar year (CY) 2021 outpatient prospective payment system (OPPS)/ambulatory surgical center (ASC) proposed rule.
Feb 21, 2020
The AHA, joined by the Association of American Medical Colleges and a number of member hospitals, filed a brief urging the U.S. Court of Appeals for the District of Columbia Circuit to affirm a district court ruling that voided the Centers for Medicare…
Feb 11, 2020
The U.S. Court of Appeals for the D.C. Circuit will hear oral arguments April 17 in the Department of Health and Human Services’ appeal of a district court ruling in favor of the AHA and hospital organizations that found the agency could not reduce calendar year 2019 payments for hospital…
Feb 10, 2020
President Trump today submitted to Congress his budget request for fiscal year 2021.
Jan 30, 2020
The Centers for Medicare & Medicaid Services has identified the Healthcare Common Procedure Coding System billing codes for hospital outpatient services that will require prior authorization starting July 1 under the hospital outpatient prospective payment system final rule for calendar year 2020.