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CMS Issues CY 2015 OPPS Proposed Rule

The Centers for Medicare & Medicaid Services (CMS) released July 3 the calendar year (CY) 2015 Outpatient Prospective Payment System (OPPS) proposed rule. Among CMS’ proposals are the following, which, if finalized, would take effect Jan. 1, 2015:

  • CMS proposes to increase payment rates by an outpatient department fee schedule increase factor of 2.1 percent for CY 2015.
  • CMS proposes to begin collecting data on services provided in off-campus, provider-based departments by requiring hospitals and physicians to identify these services using a modifier on hospital and physician claims.
  • With regard to its CY 2014 proposal to collapse codes for emergency department (ED) visits, the agency notes that it will continue to assess the most suitable payment structure for ED visits and will delay any changes in ED visit coding until it has studied the issue appropriately.
  • Starting January 2015, CMS proposes to implement its proposal from last year to establish comprehensive ambulatory payment classifications (APCs) for device-dependent services, including the addition of two new comprehensive APCs.
  • CMS proposes to remove three measures and add one measure to the Hospital Outpatient Quality Reporting Program.

Comments on the proposed rule are due to CMS Sept. 2. America’s Essential Hospitals will send a more detailed summary of the proposed rule to members in the coming days. Please contact Xiaoyi Huang, JD, director of policy, at xhuang@essentialhospitals.org or 202.585.0127 with questions.

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About the Author

Shahid Zaman is a senior policy analyst at America's Essential Hospitals.

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