Medicare OPPS and ASC 2021 Final Rule

On December 2nd, the Centers for Medicare and Medicaid Services (CMS) released a final rule that updates the Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System for calendar year 2021. The final rule increases both OPPS and ASC payment rates by 2.4 percent and updates regulations regarding hospital Star Rating methodology, while expanding the scope of services that can be provided on an outpatient basis.

In addition to finalizing a number of payment and policy changes, the rule includes a comment period on the new reporting requirements for hospitals during the COVID-19 Public Health Emergency (PHE), and the revisions to the Radiation Oncology (RO) Model. CMS will accept comments on these portions until January 31, 2021.

The attached document summarizes major provisions of the final rule. The full text is available here.