CMS is holding its annual Advisory Panel on Hospital Outpatient Payment meeting on August 21-22 2017.  The purpose of the Panel is to advise HHS and CMS on ambulatory payment classification (APC) clinical integrity and weights and hospital outpatient therapeutic services supervision issues.  Topics that may be considered during the meeting include:

  • Whether procedures within an APC group are similar both clinically and in terms of resource use.
  • Packaging of OPPS services and costs, including the methodology and the impact on APC groups and payment.
  • Removing procedures from the inpatient-only list for payment under the OPPS.
  • Using single and multiple procedure claims data for APC group weights.
  • Technical issues concerning APC group structure.
  • The appropriate supervision level (general, direct, or personal) for individual hospital outpatient therapeutic services.

The panel will not consider comments related to the OPPS conversion factor, charge compression, cost report revisions, pass-through payments, correct coding, new technology applications, provider payment adjustments, supervision of hospital outpatient diagnostic services, or the types of practitioners that are permitted to supervise hospital outpatient services, nor will the panel recommend that services be designated as nonsurgical extended duration therapeutic services. Registration is required to participate in the meeting.

This article is presented for informational purposes only and is not intended to constitute legal advice.