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Outpatient Prospective Payment System (OPPS) Rules and Comments

Largely a fee schedule, the outpatient prospective payment system (OPPS) has been used by the federal Centers for Medicare & Medicaid Services (CMS) since 2000 for hospital outpatient services under Medicare. OPPS sets payments for individual services based on weights, conversion factors, adjustment for geographic variances, and relative value units (RVUs). RVUs capture three components of patient care: physician work, practice expense, and malpractice. Services under OPPS are classified into groups called Ambulatory Payment Classifications, which are assigned a payment rate that can vary depending on services provided.


Association Comments on Proposed Rule

Submitted September 2013.

Proposed Rule

Published July 2013.


Final Rule

Published November 2012.

Association Comments on Proposed Rule

Submitted September 2012.

Proposed Rule

Published July 2012.


Association Comments on Proposed Rule

Submitted August 2011.

Proposed Rule

Published July 2011.




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