CMS released the 2021 Proposed OPPS rule yesterday.
The Proposed Rule contains a number of notable items including:
- Increase in hospital outpatient payment rates by 2.6%
- Elimination of the Inpatient Only (IPO) list over a 3-year period
- Continued 2-year exemption from certain medical review activities related to the 2-midnight rule for newly removed procedures from the IPO list
- Increase in payments for 340B drugs
- Creation of 2 new comprehensive APCs for urology and neurostimulator services
- Expansion of covered ASC procedures
- No changes to payment status indicators
- Waiver of the 60-day delayed effective date for the final rule which will be replaced with a 30-day delay in effective date
We recommend you read the entire Proposed Rule in order to identify all of the changes applicable to your facility. The HBE team is available to assist you with the implementation of these important changes as well as provide assistance in preparing your staff through education and training.
The Proposed Rule is available here: https://s3.amazonaws.com/public-inspection.federalregister.gov/2020-17086.pdf
The fact sheet is available at: https://www.cms.gov/newsroom/fact-sheets/cy-2021-medicare-hospital-outpatient-prospective-payment-system-and-ambulatory-surgical-center#:~:text=The%20CY%202021%20OPPS%2FASC,to%20be%20active%20healthcare%20consumers.
HBE’s team of coding and compliance experts is available to assist you with external reviews of your documentation, coding and reimbursement as well as providing customized education and training for your staff. We are also available to provide assistance with conducting risk assessments, internal investigations and policy and procedure development.