2009 Proposed Payment Rules Available

The Centers for Medicare and Medicaid Services has published proposed rules for OPPS and ASC PPS in 2009.

2009 OPPS
CMS projects that proposed CY 2009 payment rates under the outpatient prospective payment system (OPPS) will result in a 3.2 percent increase in Medicare payment for providers paid under the OPPS.

The rule includes proposals to strengthen ties between payment and quality, changes to ambulatory payment classifications (APCs), and changes for partial hospitalization services. CMS will accept comments on the proposed rule until September 2 and will respond to comments in a final rule to be issued by November 1.

2009 ASC PPS
The proposed rule builds on efforts across Medicare to transform the program into a prudent purchaser of healthcare services, paying based on quality of care, not just quantity of services. CMS is proposing to add nine surgical procedures to the list of procedures for which Medicare will pay when performed in an ambulatory surgical center (ASC). 

CMS is also proposing to add five procedures to the list of office-based procedures, and to update the list of device-intensive procedures and covered ancillary services and their rates, consistent with proposals in the OPPS update. CMS will accept comments on the proposed rule until September 2, and will respond to comments in a final rule to be issued by November 1.

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