Hospital Outpatient PPS

OPPS Drugs and Biologicals with Quarterly Restated Payment Rates

Some drugs and biologicals based on ASP methodology may have payment rates that are corrected retroactively. These retroactive corrections typically occur on a quarterly basis as a part of the OPPS payment system quarterly update change request. Beginning with the January 2015 OPPS payment system quarterly update change request, the list of drugs and biologicals with corrected payments rates, for a particular quarter, are accessible from the left menu link titled "Restated Drug and Biological Payment Rates".

Hospital Outpatient Prospective Payment System Rulemaking

The CY2021 OPPS/ASC Notice of Final Rulemaking with Comment Period (NFRM) (CMS-1736-FC) including related links to the CY2021 NFRM OPPS Payment Rate addenda are now available. Also available is the CY 2021 Inpatient Only (IPO) list, which is accessible on the CMS website: Addendum E. —Final HCPCS Codes that Would Be Paid Only as Inpatient Procedures for 2021

Hospital Center

For a one-stop resource web page focused on the informational needs and interests of Medicare Fee-for-Service (FFS) hospitals, go to the Hospital Center (see under "Related Links Inside CMS" below). Mailbox:

For files to order, see Limited Data Set Files - Hospital Outpatient Prospective Payment System and the Identifiable Data Files.  

Page Last Modified:
01/04/2021 07:56 PM