The Hospital Outpatient Prospective Payment System (OPPS) is the payment system Medicare uses for outpatient services, including Medicare partial hospitalization services provided to beneficiaries with mental and addictive disorders.
NAPHS advocates for appropriate access and coverage for Medicare beneficiaries receiving outpatient services.
CMS final rule on Medicare Hospital Outpatient Prospective Payment System (including CY14 partial hospitalization rates). See pages 75045-75054.
NAPHS comment letter on proposed Medicare hospital outpatient prospective payment system/partial hospitalization program (OPPS/PHP) rates for CY14
OIG Report: "Vulnerabilities in CMS's and Contractors' Activities To Detect and Deter Fraud in Community Mental Health Centers" (OEI-04-11-00101)
CMS final rule with comment period: "CMS-1589-FC: Medicare: Hospital Outpatient Prospective Payment System..." (including CY13 partial hospitalization rates, pages 68404-68418).
NAPHS comment letter on proposed Medicare hospital outpatient prospective payment system/partial hospitalization program (OPPS/PHP) rates for CY13 [View]
OIG report on "Questionable Billing by Community Mental Health Centers" [View]
CMS final decisions on the recommendations of the Hospital Outpatient Payment Panel on supervision levels for select services (also see 5/18/12 NAPHS comment letter) [View]
NAPHS comment letter on CMS' preliminary decisions on the recommendations of the Hospital Outpatient Panel on Supervision Levels for Select Services
MedLearn Matters article (MM7672): January 2012 Update of the Hospital Outpatient Prospective Payment System [View]
CMS final rule: "Medicare Hospital Outpatient Prospective Payment, etc." including partial hospital rates for 2012 (see pages 74346-74352) [View]
CMS clarifies outpatient supervision policy (Transmittal 128) [View]
Tricare final rule: Hospital-based psychiatric partial hospital programs (TRICARE approval of a hospital is sufficient for its psychiatric partial hospitalization program to be an authorized TRICARE provider) [View]
Medically unnecessary edits (MUEs) for certain partial hospitalization codes [View]
Recurring: CMS: outpatient PPS pricers (check periodically for most recent) [View]