Medicare Payment and Reimbursement

CY17 OPPS Final Rule Summary

December 15, 2016 10:11 am

The Centers for Medicare & Medicaid Services (CMS) released the calendar year 2017 [1] final rule with comment for Medicare’s hospital outpatient prospective payment system (OPPS) and ambulatory surgical center (ASC) payment system on November 1, 2016; policies in the final rule generally take effect on January 1, 2017. The final rule with comment also includes an interim final rule with comment that will pay certain off-campus provider-based departments a Medicare Physician Fee Schedule (MPFS) amount equal to 50 percent of the OPPS payment. 

 

The final rule updates OPPS payment policies that apply to outpatient services provided to Medicare beneficiaries by general acute care hospitals, inpatient rehabilitation facilities, inpatient psychiatric facilities, long-term acute care hospitals, children’s hospitals, and cancer hospitals, as well as for partial hospitalization services in community mental health centers (CMHCs). The document also includes updates and refinements to the requirements for the Hospital Outpatient Quality Reporting (OQR) Program and the ASC Quality Reporting (ASCQR) Program.

Addenda containing relative weights, payment rates, wage indices and other payment information are available only on the CMS website.

Download the fact sheet

 

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