- Regulation No.
- Hospital Outpatient Prospective Payment- Notice of Final Rulemaking with comment (NFRM)
Medicare Program: Changes to Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems and Quality Reporting Programs
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 2019 to implement 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. In addition, we are updating the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) Survey measure under the Hospital Inpatient Quality Reporting (IQR) Program by removing the Communication about Pain questions; and retaining two measures that were proposed for removal, the Catheter‑Associated Urinary Tract Infection (CAUTI) Outcome Measure and Central Line-Associated Bloodstream Infection (CLABSI) Outcome Measure, in the PPS-Exempt Cancer Hospital Quality Reporting (PCHQR) Program beginning with the FY 2021 program year.
- CMS-1695-FC (PDF) - Opens in a new window
- CMS-1695-FC (Text) - Opens in a new window
- CY2019 NFRM OPPS Cost Statistics Files - Opens in a new window
- CY2019 NFRM OPPS “Data Addendum B” and “2 Times Rule” File - Opens in a new window
- CY2019 NFRM OPPS Addenda Table of Contents - Opens in a new window
- CY2019 NFRM OPPS Addenda - Opens in a new window
- CY2019 NFRM OPPS Facility-Specific Impacts - Opens in a new window
- CY2019 NFRM OPPS Blood Revenue Code Cost to Charge Ratios - Opens in a new window
- CY2019 NFRM OPPS Revenue Code-to-Cost Center Crosswalk - Opens in a new window
- FY 2019 Wage Index Home Page
- Final Changes with comment to the Ambulatory Surgical Center Payment System and CY 2019 Payment Rates