- Regulation No.
- Hospital Outpatient Prospective Payment- Proposed Rule and Proposed CY2016 Payment Rates
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.
- CMS-1633-P (PDF Version) - Opens in a new window
- CMS-1633-P (Text Version) - Opens in a new window
- 2016 OPPS NPRM Cost Statistics Files - Opens in a new window
- 2016 OPPS NPRM “Data Addendum B” and “2 Times Rule” File - Opens in a new window
- 2016 OPPS NPRM Skin Substitute Threshold Analysis - Opens in a new window
- 2016 OPPS NPRM Addenda Table of Contents - Opens in a new window
- 2016 OPPS NPRM Addenda - Opens in a new window
- 2016 OPPS NPRM Addendum N (Updated 7/22/2015) - Opens in a new window
- 2016 OPPS NPRM Facility-Specific Impacts - Opens in a new window
- 2016 OPPS NPRM Blood Revenue Code Cost to Charge Ratios - Opens in a new window
- FY 2016 Wage Index Home Page
- Proposed Changes to the Ambulatory Surgical Center Payment System and CY 2016 Payment Rates - Opens in a new window