Healthcare News: CMS releases 2017 OPPS final rule

Why This Topic Matters

The rule affects how certain hospital outpatient services are paid and reported, including site-neutral payment policy implementation, APC changes, packaging adjustments, and select modifier usage. Readers who handle outpatient billing or coding need to know what changed and when the policies take effect.

Article Sections

1. OPPS final rule overview and effective date

   Introduces the final rule and summarizes the main outpatient payment policy areas addressed by CMS. It also notes the general effective date for the finalized policies.

2. Site-neutral payment policy for nonexcepted off-campus departments

   Covers CMS’s implementation of payment changes for certain off-campus hospital outpatient departments and the distinction between excepted and nonexcepted facilities. It also discusses billing and reporting impacts at a high level.

3. Reporting and service-line implications for excepted and nonexcepted departments

   Discusses operational effects for off-campus provider-based departments, including reporting considerations and CMS monitoring of future expansion and relocation issues.

4. New comprehensive APCs and packaging policy updates

   Summarizes additions to the APC structure, the creation of new clinical families, and broader packaging-related refinements. It also notes policy changes affecting laboratory test packaging and related reporting.