Medicare Program: Changes to Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs
This final rule with comment period revises the Medicare hospital outpatient prospective payment system (OPPS) and the Medicare ambulatory surgical center (ASC) payment system for CY 2019 to implement changes arising from our continuing experience with these systems. In this final rule with comment period, we describe the changes to the amounts and factors used to determine the payment rates for Medicare services paid under the OPPS and those paid under the ASC payment system. In addition, this final rule with comment period updates and refines the requirements for the Hospital Outpatient Quality Reporting (OQR) Program and the ASC Quality Reporting (ASCQR) Program. In addition, we are updating the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Survey measure under the Hospital Inpatient Quality Reporting (IQR) Program by removing the Communication about Pain questions; and retaining two measures that were proposed for removal, the Catheter‑Associated Urinary Tract Infection (CAUTI) Outcome Measure and Central Line-Associated Bloodstream Infection (CLABSI) Outcome Measure, in the PPS-Exempt Cancer Hospital Quality Reporting (PCHQR) Program beginning with the FY 2021 program year.
The final rule with comment (CMS-1695-FC) is available in the "Related Links" section below. The supporting files are located in the "Downloads" section below:
Downloads
- CY2019 NFRM ASC Addenda Table of Contents
- CY2019 NFRM OPPS Addendum A
- CY2019 NFRM ASC Supplier Specific Files (CMS-1695-FC-FR-ASC)
- CY2019 NFMR OPPS Addendum O
- FY 2019 Pre-reclass Wage Index for Use in Calculating Payments Effective for Services Furnished Beginning January 1, 2019 Under the Revised ASC Payment System
- CY2019 NFRM OPPS Relative Weights without C-APC Methodology for ASC Ratesetting