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CMS Releases 2021 Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System Proposed Rule

Members & Publications

August 6, 2020

On August 4, 2020, the Centers for Medicare & Medicaid Services (CMS) released the 2021 Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System (OPPS/ASC) Proposed Rule.

The rule addresses several proposed new policies which, if implemented, would move the payment system toward site neutrality. The rule proposes elimination of the Inpatient Only List over a 3-year transitional period, making many new procedures eligible for payment in the hospital outpatient setting. Further, CMS is proposing to expand the ASC Covered Procedures List, to allow for coverage of many new procedures when performed in the ASC.

Your Academy is working to review this new proposed rule in detail and will share further information as it becomes available. CMS has published a fact sheet, detailing specifics from the rule. 

Legislation Introduced to Alleviate Impact of Conversion Factor Cut for 2021

Nov 09, 2020

Last month, two bills were introduced in the House proposing solutions to the estimated 10.6% Physician Fee Schedule conversion factor cut expected to go into effect January 1, 2021.  The bills offer some relief to the cut, but do not reflect a comprehensive or long-term solution.  AAPM&R has therefore chosen to remain neutral regarding these bills. 

Your Academy continues to advocate for a permanent solution to the conversion factor cut while maintaining the important payment increases to office and outpatient evaluation and management services.

 

 

 

 

 

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