On November 2nd, the Centers for Medicare and Medicaid Services (CMS) finalized a rule that will update the Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Centers (ASCs) Payment System for 2019. The rule will increase OPPS rates by 1.35% and ASC payment rates by 2.1%. Notable rule changes will affect off-campus provider-based department rates, ASC covered procedure lists, ASC covered device-intensive procedures, quality reporting, and other areas.
In addition to finalizing a number of payment and policy changes, the rule includes a comment period for proposed changes to the Partial Hospitalization Program Ambulatory Payment Classifications (PHP APC) code set, which were outlined in the 2019 Hospital OPPS proposed rule, but not included in the PHP section. CMS is requesting comment again to ensure that PHP providers see the proposed change. CMS will accept comments until December 3rd.
A summary of the final rule is attached, and the 1,182 page final rule is available here.