Hospital Outpatient Regulations and Notices

This proposed rule would revise 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 proposed rule, we describe the proposed 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 would be applicable to services furnished on or after January 1, 2010.

In addition, this proposed rule would update 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 proposed rule, we set forth the applicable relative payment weights and amounts for services furnished in ASCs, specific HCPCS codes to which these proposed changes would apply, and other pertinent ratesetting information for the CY 2010 ASC payment system. These proposed changes would be applicable to services furnished on or after January 1, 2010.

Downloads
CLARIFICATION IN DRUG ANALYSIS DISCUSSION [PDF, 41KB] Median Files [ZIP, 788KB] Addenda [ZIP, 1.26MB] 2010 OPPS Facility-Specific Impacts [ZIP, 602KB] Blood Revenue Code cost to Charge Ratios [ZIP, 190KB] 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, 67KB] 2010 OPPS Without Cost or With Credit Device Information [PDF, 37KB] 2010 Offset Amounts by APC [ZIP, 62KB] 2010 OPPS/ASC Preamble Tables [ZIP, 160KB]
Related Links Inside CMS
Proposed Changes to ASC Payment System and CY 2010 Payment Rates OPPS Limited Data Set
Related Links Outside CMS
CMS-1414-P (Publication Date: July 20, 2009) -- Text format and PDF format [PDF, 44MB] CMS-1412-N: Medicare Program; Second Semi-Annual Meeting of the Advisory Panel on Ambulatory Payment Classification Groups--August 5-7, 2009 (Publication Date: July 6, 2009) -- Text format and PDF format