Device Related Portions of Ambulatory Payment Classification Costs for 2005 As we state in the proposed rule to update the OPPS for CY 2005 (CMS-1427-P), we will review each pass-through device category on a case-by-case basis to determine whether device costs are packaged into the existing APC structure. Currently, we propose that there are none for the remaining 3 categories for 2005, and, therefore, we propose to set the offsets to $0. If, during 2005, we create a new device category and determine that our data contain identifiable device costs within the APCs, we would adjust the pass-through payment by means of adjusting the APC payment associated with the device, if the offset amount is greater than $0. We would announce such an offset amount in the program transmittal that announces the new device category. For 2005, we are proposing to use the device percentages that we developed for potential offsets in CY 2004, and apply those percentages to the CY 2005 payment amounts to obtain the 2005 offset amounts.
Downloads
- Addendum C - This Excel file groups HCPCS codes proposed for payment under the 2005 OPPS by APC.
- Addendum L - Pre-Reclassified Wage Index for Urban Areas
- Addendum H - Wage index for urban areas
- Addendum I - Wage index for rural areas
- CMS-1427-P - Medicare Program; Proposed Changes to the Hospital Outpatient Prospective Payment System and Calendar Year 2005 Payment Rates, Published at the Federal Register August 16, 2004.
- cms-1427-p_drugmedians.zip
- Addendum N - Hospital Reclassifications and Redesignations by Individual Hospital Under Section 508 of Pub.L. 108-173
- Hospital-Specific Impacts - File layout
- cms-1427-p_apcmedians.zip
- Addendum K - Wage Index Adjustment for Commuting Hospital Employees
- Addendum M - Pre-Reclassified Wage Index for Rural Areas
- cms-1427-p_cptmedians.zip
- Hospital-Specific Impacts - Provider-specific data
- 2005 OPPS Claims Accounting -
- Addendum D : Addendum D1 lists the 2005 OPPS payment status indicators and what they signify; Addendum D2 describes proposed comment codes proposed for assignment to new and deleted HCPCS codes in Addendum B.
- Addendum E - This Excel file lists HCPCS codes that would only be payable as inpatient procedures (inpatient list).
- Addendum A - This Excel file lists, in APC order, the name, payment status indicator, relative weight, payment rate, and copayment amount(s) proposed for the 2005 APC groups.
- Addendum J - Wage index for hospitals that are reclassified.