CMS releases outpatient prospective payment rule

Editor's Note

The Centers for Medicare & Medicaid Services (CMS) on July 25 released its 2019 outpatient prospective payment rule, which includes cutting payments for hospital outpatient clinic visits as part of a site neutral payment policy. CMS estimated this would save patients about $150 in lower copayments for clinic visits provided at off-campus hospital outpatient departments and reduce Medicare expenditures by $760 million.

Demonstrating commitment to its Meaningful Measures initiative, CMS is also proposing to remove 10 measures from the Outpatient Quality Reporting Program.

For ambulatory surgery centers (ASCs), CMS is proposing to:

• expand the number of procedures payable at ASCs
• ensure that ASC payments for procedures that involve high-cost devices parallel the amount provided to hospital outpatient departments
• help ensure ASC competitiveness by stabilizing the differential between ASC and hospital outpatient department payment rates.

Comments on the proposed rule are due September 24, 2018.