BC Advantage - 2017 Issue 11
Four Final Rules Affecting CMS Payments for 2018
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Article Overview
This article provides a high-level overview of four CMS final rules issued for 2018 and explains the general areas they affect, including physician payment, hospital outpatient and ambulatory surgery payments, home health agency payments, and the second year of the Quality Payment Program. It is useful for physicians, coders, billers, compliance staff, and revenue cycle professionals who need to understand where CMS payment and quality policy changes are taking place and what broad program areas are being updated. The article also points readers to related CMS materials such as final rules, fact sheets, executive summaries, and press releases.
Why This Topic Matters
These annual CMS payment and quality rules can change reimbursement, reporting expectations, and participation requirements across multiple care settings. Knowing which programs are affected helps organizations review the full rule text and prepare for operational and compliance updates.
Article Sections
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Physician Fee Schedule
Overview of the physician payment rule and related policy updates affecting Medicare payment, reporting, and service categories. The section summarizes broad changes and areas of ongoing CMS attention.
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Hospital OPPS and ASC Payment System and Quality Reporting Programs
Summary of the hospital outpatient and ambulatory surgery payment rule, including payment updates and quality reporting program topics. The section also notes several areas addressed in the final rule for these settings.
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HHAs: Payment Changes
Discussion of the home health agency payment update for 2018 and related policy changes. The section covers the main payment and program areas affected.
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Quality Payment Program Rule for Year 2
Summary of the second-year Quality Payment Program rule, including MIPS-related updates and participation flexibilities. The section outlines the general categories of transition-year policy changes.
What You Will Learn
- Which CMS payment systems are affected by the 2018 final rules
- What broad policy areas are included in the physician payment rule
- What topics are addressed in the hospital outpatient and ASC rule
- What types of changes were made for home health agencies
- What the second-year Quality Payment Program rule covers at a high level
Who Should Read This
- Physicians
- Medical coders
- Medical billers
- Compliance staff
- Revenue cycle professionals
- Practice administrators
- Hospital outpatient departments
- Ambulatory surgery centers
- Home health agencies
Codes Discussed
Code Ranges Discussed
Modifiers Discussed
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