- Regulation No.
- Ambulatory Surgical Center Payment - Proposed Rule
Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs; Short Inpatient Hospital Stays; Transition for Certain Medicare-Dependent, Small Rural Hospitals under the Hospital Inpatient Prospective Payment System
This proposed rule would revise the Medicare hospital outpatient prospective payment system (OPPS) and the Medicare ambulatory surgical center (ASC) payment system for CY 2016 to implement applicable statutory requirements and changes arising from our continuing experience with these systems. In this proposed rule, we describe the proposed 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 proposed rule would update and refine the requirements for the Hospital Outpatient Quality Reporting (OQR) Program and the ASC Quality Reporting (ASCQR) Program.
Further, this proposed rule includes certain proposals relating to the hospital inpatient prospective payment system: proposed changes to the 2-midnight rule under the short inpatient hospital stay policy, as well as a discussion of the related ‑0.2 percent payment adjustment; and a proposed transition under the hospital inpatient prospective payment system for Medicare‑dependent, small rural hospitals located in all-urban States.
The proposed rule (CMS-1633-P) is available in the "Related Links" section below. The supporting files are located in the "Downloads" section below:
- ASC Addenda Table of Contents [PDF, 47KB]
- ASC Addendum A [ZIP, 78KB]
- ASC Addendum O [PDF, 158KB]
- CY 2016 NPRM OPPS Relative Weights without C-APC Methodology for ASC Ratesetting [ZIP, 152KB]
- FY 2016 Pre-reclass Wage Index for Use in Calculating Payments Effective for Services Furnished Beginning January 1, 2016 Under the Revised ASC Payment System [ZIP, 34KB]
- ASC Supplier Specific Files [ZIP, 1004KB]
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- CMS-1633-P (PDF Version) - Opens in a new window
- CMS-1633-P (Text Version) - Opens in a new window
- Addendum AA, BB, DD1, DD2 and EE - Opens in a new window
- 2016 OPPS NPRM Cost Statistics Files - Opens in a new window
- Proposed Changes to the Hospital Outpatient Prospective Payment System and CY 2016 Payment Rates - Opens in a new window