BC Advantage - 2024 Issue 7
Hospital Outpatient Prospective Payment System
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Article Overview
This article summarizes July 1, 2024 outpatient payment system updates from CMS, including new and revised HCPCS and CPT-related items, device pass-through activity, drug and biological payment updates, skin substitute packaging policy, and a reminder about Medicare coverage determinations. It is useful for hospital outpatient departments, billing teams, suppliers, and compliance staff who need to track current OPPS-related changes and their operational impact.
Why This Topic Matters
The update helps outpatient billing and reimbursement teams stay current with CMS payment and coding changes that affect claim processing, charge capture, and coverage review under Medicare.
What You Will Learn
- Which broad OPPS and Medicare outpatient topics were updated for July 2024
- How CMS is addressing new coding and payment categories in the outpatient setting
- What general areas of drug, biological, device, and skin substitute policy were updated
- Why Medicare coverage and payment decisions should be reviewed separately
Who Should Read This
- Hospital outpatient billing staff
- Revenue cycle and reimbursement professionals
- Coding and compliance teams
- Medical device and pharmaceutical suppliers
- Medicare contractors and policy analysts
Codes Discussed
Code Ranges Discussed
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