Hospital Outpatient Regulations and Notices

Medicare Program:  Changes to the Hospital Outpatient Prospective Payment System and CY 2010 Payment Rates; Changes to the Ambulatory Surgical Center Payment System and CY 2010 Payment Rates

Summary:  This final rule with comment period revises the Medicare hospital outpatient prospective payment system (OPPS) to implement applicable statutory requirements and changes arising from our continuing experience with this system.  In this final rule with comment period, we describe the changes to the amounts and factors used to determine the payment rates for Medicare hospital outpatient services paid under the prospective payment system.  These changes are applicable to services furnished on or after January 1, 2010.

In addition, this final rule with comment period updates the revised Medicare ambulatory surgical center (ASC) payment system to implement applicable statutory requirements and changes arising from our continuing experience with this system.  In this final rule with comment period, we set forth the applicable relative payment weights and amounts for services furnished in ASCs, specific HCPCS codes to which these changes will apply, and other pertinent ratesetting information for the CY 2010 ASC payment system.  These changes are applicable to services furnished on or after January 1, 2010.

The final rule (CMS-1414-FC) is available in the "Related Links Outside CMS" below.  The data files are located in the "Downloads" section below.

Downloads
OPPS GUIDANCE FOR SUBMITTING RADIOPHARMACEUTICAL ASP DATA - 10/30/2009 Median Files [ZIP, 788KB] Addenda [ZIP, 1.17MB] 2010 OPPS Facility-Specific Impacts [ZIP, 673KB] Blood Revenue Code cost to Charge Ratios [ZIP, 221KB] FY 2010 IPPS Wage Index, Tables 4A, 4B, 4C, 4F, 9A, and 9C [ZIP, 441KB] Out-Migration Wage Adjustment for CY 2010 [ZIP, 49KB] 2010 OPPS Claims Accounting [PDF, 169KB] 2010 OPPS Without Cost or With Credit Device Information - APC Offset List [PDF, 19KB] 2010 OPPS Without Cost or With Credit Device Information - Device Offset List [PDF, 18KB] 2010 Offset Amounts by APC [ZIP, 62KB] 2010 OPPS/ASC Preamble Tables [ZIP, 160KB]
Related Links Inside CMS
Final Changes to ASC Payment System and CY 2010 Payment Rates OPPS Limited Data Set
Related Links Outside CMS
CMS-1414-FC " Published November 20, 2009 [PDF, 45MB] CMS-1414-FC " Published November 20, 2009 (Text version)