fbpx

< Back to Thought Leadership

2019 Hospital OPPS Proposed Rule

On July 25, the CMS released proposed changes to the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System for 2019.

Key proposals include:

  • Increasing the OPPS payment rates by a factor of 1.25% and to increase ASC rates by 2.0%.
  • Applying a Physician Fee Schedule-equivalent payment rate for clinic visits provided at all off-campus provider-based department (PBD) that is paid under OPPS. This proposal would reduce the OPPS payment rate for the clinic visit (HCPCS code G0463) to $46 (from $116).
  • Revising the ASC definition of “surgery” for CY 2019 to account for “surgery-like” procedures, specifically adding some cardiovascular codes (including 12 cardiac catheterization procedures) to the covered procedures list.

The Proposed Rule also includes proposed changes and Requests for Information (RFI) in areas such as price transparency, quality reporting, the Competitive Acquisition Program, among others. The CMS fact sheet is available at the link below. Comments are due no later than September 24, 2018.

CMS.gov 2018-Fact-sheets items

If you have questions or would like to discuss, please contact Scott Treida at 317-713-7950 or streida@blueandco.com.

Physician Fee Schedule: 2023 CMS Final Ruling

The Centers for Medicare & Medicaid Services (CMS) operates within a budget neutral approach. This occurs at the same time the healthcare community continues to try and find balance between reducing administrative burdens, accurately recognizing and recording services provided, and upholding the highest quality care possible. Over the last three years, there have been significant […]

Learn More
Blue & Co., LLC acquires Alerding CPA Group

Blue & Co., LLC acquires Alerding CPA Group

Carmel, Ind. (November 23, 2022) – The accounting and consulting firms of Alerding CPA Group (Indianapolis, Ind.) and Blue & Co., LLC (Carmel, Ind.) have announced their merger. The combined firm will operate as Blue & Co., LLC (Blue & Co.), effective December 1, 2022. This acquisition will provide Blue & Co. with greater market […]

Learn More

Not-for-Profit Single Audit Requirements – Evaluation of Revenue Sources

By: Holly Fields, CPA, Senior Manager Not-for-profit organizations (NFPs) that receive federal financial assistance over certain levels, either directly from a federal agency or indirectly through state or local agencies, may be required to have a single audit performed under Federal Uniform Guidance. Single Audit Requirements A single audit includes not only an audit of […]

Learn More