Healthcare News: CMS releases CY 2021 OPPS and MPFS final rules

Why This Topic Matters

The final rules influence how common outpatient and physician services are coded, billed, and paid under Medicare. They also affect telehealth availability, hospital outpatient policy, and reimbursement for 340B-acquired drugs, making them important for organizations that rely on Medicare payment updates.

Article Sections

1. MPFS updates

   Overview of the Medicare Physician Fee Schedule changes discussed in the article, including broad updates to outpatient visit coding and payment. Also summarizes how the rule affects physician reimbursement trends across specialties.

2. Telehealth updates

   Summary of telehealth-related additions finalized under the MPFS rule, including new categories of services and general groupings of covered specialties and visit types.

3. OPPS updates

   Overview of outpatient prospective payment policy updates for hospitals, including major rulemaking areas addressed in the final rule and the overall regulatory direction for 2021.

4. Phasing out the IPO list

   Discussion of the staged transition away from the inpatient-only list and the types of outpatient procedures affected by the 2021 policy changes.

5. 340B drug payment policy to continue

   Summary of the continued Medicare payment policy for drugs acquired under the 340B program and the hospital types discussed in connection with that policy.