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Outpatient prospective payment
Background
News

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.

12/10/2013

CMS final rule on Medicare Hospital Outpatient Prospective Payment System (including CY14 partial hospitalization rates).  See pages 75045-75054.

8/22/2013

NAPHS comment letter on proposed Medicare hospital outpatient prospective payment system/partial hospitalization program (OPPS/PHP) rates for CY14

7/19/2013

CMS proposed rule on the Medicare outpatient prospective payment system/partial hospitalization program (OPPS/PHP) rates for CY14. Also see 9.6.13 correction.

1/14/2013

OIG Report: "Vulnerabilities in CMS's and Contractors' Activities To Detect and Deter Fraud in Community Mental Health Centers" (OEI-04-11-00101) 

11/15/2012

CMS final rule with comment period: "CMS-1589-FC: Medicare: Hospital Outpatient Prospective Payment System..." (including CY13 partial hospitalization rates, pages 68404-68418).

8/23/2012

NAPHS comment letter on proposed Medicare hospital outpatient prospective payment system/partial hospitalization program (OPPS/PHP) rates for CY13 [View]

8/21/2012

OIG report on "Questionable Billing by Community Mental Health Centers" [View]

5/22/2012

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]

5/18/2012

NAPHS comment letter on CMS' preliminary decisions on the recommendations of the Hospital Outpatient Panel on Supervision Levels for Select Services

12/29/2011

MedLearn Matters article (MM7672): January 2012 Update of the Hospital Outpatient Prospective Payment System [View]

11/30/2011

CMS final rule: "Medicare Hospital Outpatient Prospective Payment, etc." including partial hospital rates for 2012 (see pages 74346-74352) [View]

5/28/2010

CMS clarifies outpatient supervision policy (Transmittal 128) [View]

10/29/2009

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]

1/1/1990

Medically unnecessary edits (MUEs) for certain partial hospitalization codes [View]

1/1/1990

Recurring: CMS: outpatient PPS pricers (check periodically for most recent) [View]

Show Archived List Items

Official CMS Web site on Hospital Outpatient Prospective Payment System


RECURRING: