Final Rule, Medicare Program: Changes To Hospital Outpatient Prospective Payment & Ambulatory Surgical Center Payment Systems & Quality Reporting Programs

This document is a final rule issued on November 21, 2018, by the Centers for Medicare & Medicaid Services (CMS). The rule reduces the rate of Medicare payments to hospital outpatient clinics located off the hospital campus. CMS intends to pay the same rate for a clinic visit in the hospital outpatient setting in the physician office setting. Clinic visits are the most common service billed under the Medicare Outpatient Prospective Payment System (OPPS). Currently Medicare pays more for a visit in the hospital outpatient setting than in the clinical professional office setting . . .