CMS did not have a choice about implementing site-neutral payment policies after Congress passed Section 603 of the Bipartisan Budget Act of 2015, but providers hope the agency will reconsider some of the provisions to operationalize the policy introduced in the 2017 OPPS proposed rule.
This week’s Medicare updates include the October 2016 Integrated Outpatient Code Editor specifications version 17.3; the Medicare Fee for Service (FFS) Recovery Audit program third quarter summary newsletter; and more!
CMS’ proposed changes to implement Section 603 of the Bipartisan Budget Act of 2015 and reshape payments for off-campus, provider-based departments represent the most significant changes in the current year 2017 OPPS proposed rule.
CMS has proposed several changes for status and comment indicators in the 2017 OPPS proposed rule in an attempt to better identify codes and services for providers.
The August 2 issue of Revenue Cycle Daily Advisor included a question about benchmark conversion rates from observation to inpatient status. With regard to that question, I think it may be helpful to know the average national conversion rate and average rate for critical access hospitals. Do you have that information?
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Acknowledging comments received from providers regarding policies in the 2016 OPPS proposed rule, CMS is proposing for 2017 that procedures with a HCPCS code-level device offset of more than 40% of the APC costs would be designated as device-intensive procedures and subject to those applicable payment policies.
