- Regulation No.
- Ambulatory Surgical Center Payment- Final Rule
Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs; Organ Procurement Organization Reporting and Communication; Transplant Outcome Measures and Documentation Requirements; Electronic Health Record (EHR) Incentive Programs; Payment to Nonexcepted Off-Campus Provider-Based Department of a Hospital; Hospital Value-Based Purchasing (VBP) Program; Establishment of Payment Rates under the Medicare Physician Fee Schedule for Nonexcepted Items and Services Furnished by an Off-Campus Provider-Based Department of a Hospital
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 2017 to implement applicable statutory requirements and 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.
Further, in this final rule with comment period, we are making changes to tolerance thresholds for clinical outcomes for solid organ transplant programs; to Organ Procurement Organizations (OPOs) definitions, outcome measures, and organ transport documentation; and to the Medicare and Medicaid Electronic Health Record Incentive Programs. We also are removing the HCAHPS Pain Management dimension from the Hospital Value-Based Purchasing (VBP) Program.
In addition, we are implementing section 603 of the Bipartisan Budget Act of 2015 relating to payment for certain items and services furnished by certain off-campus provider-based departments of a provider. In this document, we also are issuing an interim final rule with comment period to establish the Medicare Physician Fee Schedule payment rates for the nonexcepted items and services billed by a nonexcepted off-campus provider‑based department of a hospital in accordance with the provisions of section 603.
The final rule with comment (CMS-1656-FC) is available in the "Related Links" section below. The supporting files are located in the "Downloads" section below:
- ASC Addenda Table of Contents [PDF, 13KB]
- Addendum A [ZIP, 78KB]
- Addendum O [ZIP, 31KB]
- 2017 Final Rule with Comment OPPS Relative Weights without C-APC Methodology for ASC Ratesetting [ZIP, 282KB]
- FY 2017 Pre-reclass Wage Index for Use in Calculating Payments Effective for Services Furnished Beginning January 1, 2017 Under the Revised ASC Payment System [ZIP, 31KB]
- ASC Supplier Specific Files [ZIP, 893KB]
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- CMS-1656-FC (PDF) - Opens in a new window
- CMS-1656-FC (Text) - Opens in a new window
- Addendum AA, BB, DD1, DD2 and EE - Opens in a new window
- 2017 Final Rule OPPS Cost Statistics Files - Opens in a new window
- Proposed Changes to the Hospital Outpatient Prospective Payment System and CY 2017 Payment Rates