Course | Basic | Medicare Payment and Reimbursement
In this course we will address scheduling processes, including<div><ul><li>Patient identification</li><li>Requested service</li><li>Medical necessity screening</li><li>Medicare Advance Beneficiary Notice of Noncoverage processing</li><li>Pa...
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Course | Overview | Medicare Payment and Reimbursement
This course provides a brief history and overview of Medicare and Medicaid. It describes government organizations that regulate and administer this program. This course also discusses Medicare reimbursement. In addition, it highlights recen...
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Course | Intermediate | Medicare Payment and Reimbursement
This course provides an overview of the prospective payment systems used in the Medicare program and as well as Medicare fee schedules. This course provides a general discussion and overview of Medicare reimbursement under the Inpatient Pro...
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Course | Intermediate | Medicare Payment and Reimbursement
This course provides a general discussion and overview of reimbursement provided by Medicare under the outpatient prospective payment system. It also discusses the use of ambulatory payment classifications in the outpatient prospective paym...
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On Demand Webinar | Intermediate | Medicare Payment and Reimbursement
As the senior population continues to outpace the relative growth of the general population, and Medicare Advantage is accounting for about one-third (and growing every year) of all new Medicare eligible enrollees, providers are increasingl...
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Fact Sheet | Medicare Payment and Reimbursement

CY16 OPPS Proposed Rule Fact Sheet

Fact Sheet | Medicare Payment and Reimbursement

CY16 OPPS Proposed Rule Fact Sheet

This document highlights the proposed prospective payment system updates to Medicare outpatient hospitals and ambulatory surgical centers for calendar year 2016 (CY16).

The Centers for Medicare &amp; Medicaid Services (CMS) released a proposed rule with comment period that would revise the Medicare hospital outpatient prospective payment system (OPPS) and the Medicare ambulatory surgical center (ASC) payment system for calendar year 2016 (CY16). In the proposed rule, CMS describes the proposed changes to the amounts and factors used to determine the payment rates for Medicare services paid under the OPPS and those paid under the ASC payment system. The proposal would also update and refine the requirements for the Hospital Outpatient Quality Reporting (OQR) Program and the ASC Quality Reporting (ASCQR) Program. Further, the proposed rule includes certain proposals relating to the hospital inpatient prospective payment system (IPPS), including the two-midnight rule under the short inpatient hospital stay policy, the related -0.2 percent payment adjustment, and a proposed transition for Medicare-dependent, small rural hospitals located in all-urban states. Additionally, the agency proposes to apply a 2 percent reduction to the CY16 conversion factor to redress the inflation in OPPS payment rates resulting from excess packaged payment under the OPPS for laboratory tests from its final CY14 laboratory packaging policy.

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