OPPS Final Rule 2011 - Make Your Revenue Smarter

OPPS Final Rule 2011

On , in Archives, by AQ-IQ LLC

Medicare OPPS Final Rule for FY2011 Published

The final rule with comment period revises the Medicare hospital outpatient prospective payment system (OPPS) to implement applicable statutory requirements and changes arising from our continuing experience with this system and to implement certain provisions of the Patient Protection and Affordable Care Act, as amended by the Health Care and Education Reconciliation Act of 2010 (Affordable Care Act). In this final rule with comment period, we describe the changes to the amounts and factors used to determine the payment rates for Medicare hospital outpatient services paid under the prospective payment system. These changes are applicable to services furnished on or after January 1, 2011.

In addition, this final rule with comment period updates the revised Medicare ambulatory surgical center (ASC) payment system to implement applicable statutory requirements and changes arising from our continuing experience with this system and to implement certain provisions of the Affordable Care Act. In this final rule with comment period, we set forth the applicable relative payment weights and amounts for services furnished in ASCs, specific HCPCS codes to which these changes apply, and other pertinent ratesetting information for the CY 2011 ASC payment system. These changes are applicable to services furnished on or after January 1, 2011.

In this document, we also are implementing provisions of the Affordable Care Act relating to payments to hospitals for direct graduate medical education (GME) and indirect medical education (IME) costs; and new limitations on certain physician referrals to hospitals in which they have an ownership or investment interest.

Final Rule Files

Each of these is a zip file for download. Each link requires CPT® license agreement.

(Note: to follow the links below, you will need to loginRegistration is still Free.)

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2011 OPPS Final Median Files [ZIP, 664KB]

2011 OPPS Final Addenda [ZIP, 1.54MB](The 2011 Inpatient Only List is here as Addendum E.)

2011 OPPS Facility-Specific Impacts [ZIP, 625KB]

2011 OPPS Final Blood Revenue Code cost to Charge Ratios [ZIP, 195KB]

Tables 2, 3A, 3B, 4A, 4B, 4C, 4D-2, 4E, 4F, 4J, 9A, 9C (Wage Index Tables) [ZIP, 449KB]

2011 OPPS Claims Accounting [PDF, 74KB]

2011 OPPS Final Without Cost or With Credit Device Information [PDF, 34KB]

2011 Offset Amounts by APC [ZIP, 53KB]

2011 OPPS Final Preamble Tables [ZIP, 218KB]{/jugaaccess}

 

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