2010 Outpatient PPS Proposed Rule Published

On July 1, the CMS released the proposed policy changes for services provided in hospital outpatient departments and ambulatory surgical centers (ASC) for 2010, under the outpatient Prospective Payment System (OPPS). The press release is found on the Medical Release Database section within CMS: http://tinyurl.com/nmx88h.

Highlights of this proposed rule include:

• Adjustment of hospital pharmacy costs for separately payable drugs.
• Changes to current physician supervision requirements for hospital outpatient services to allow for other licensed providers (such as physician assistants and nurse practitioners) to supervise when the facility’s license allows for such supervision.
• Expansion of the number of procedures Medicare will cover when performed in an ASC.
• Update of the payment rate for services provided in an ASC. 
• Continuation of the Hospital Outpatient Department Quality Reporting Program with the existing measures.
• Proposal of 16 potential measures for consideration for future OPPS updates; including health information technology, medication reconciliation and overuse/appropriate use.

The proposed rule is available at: http://edocket.access.gpo.gov/2009/pdf/E9-15882.pdf.

Comments may be submitted electronically by going to the following web site http://www.regulations.gov/search/Regs/home.html#documentDetail?R=09000064809f5cfb, and clicking on the “Submit Comment” at the top of the page to view the Public Comment and Submission Form. Comments are accepted through August 31, 2009. The final rule will be published November 1, 2009.

Written by: Kathy Lindstrom, a professional coder at Provation and a CCH & MediRegs Coding Advisory Board member.