2021 OPPS proposed rule: CMS wants to end the IPO list, move 266 ortho surgeries to outpatient setting

Why This Topic Matters

CMS policy changes in the OPPS can affect where procedures are performed, how facilities are paid, and how hospitals prepare for medical necessity review and outpatient billing changes.

Article Sections

1. Proposed changes to the inpatient-only list

   This section describes CMS’s proposal to phase out the inpatient-only framework and the general scope of procedures under consideration for transition.

2. Two-midnight rule and future comments

   This section notes CMS’s discussion of review implications for hospital stays and requests for comment on future timing, clinical groupings, and outpatient payment structure.

3. Ambulatory surgery center list proposals

   This section covers CMS’s proposed additions to the ambulatory surgery center list and the agency’s ideas for future list expansion methods.