Hospitals: Final Outpatient Rule Increases Outlier Thresholds

Article Overview

This article explains a Medicare hospital outpatient payment update for 2005 and describes how the final rule changes the framework for outpatient outlier payments compared with the proposed rule. It is relevant to hospital revenue cycle staff, outpatient coders, and reimbursement professionals who track CMS payment methodology, OPPS updates, and outlier policy. The discussion covers payment updates, APC-based outlier concepts, charge inflation adjustments, and the relationship between proposed and final thresholds.