Final rule released on OPPS and ASC

November 14, 2007

Fairfax, VA-ACRS reviewed advance copies of the 2008 MPFS final rule and a combined final rule for 2008 OPPS, which will update the payment rates for the revised ASC payment system as of the calendar year (CY) 2008. The rulings will be published by the Centers for Medicare and Medicaid Services (CMS) in the Federal Registrar Nov. 27.

Fairfax, VA-ACRS reviewed advance copies of the 2008 MPFS final rule and a combined final rule for 2008 OPPS, which will update the payment rates for the revised ASC payment system as of the calendar year (CY) 2008. The rulings will be published by the Centers for Medicare and Medicaid Services (CMS) in the Federal Registrar Nov. 27.

On Nov. 1, CMS ruled that the July proposal to keep ASC rates at 65% of OPPS rates, which is 2% less than the original final rule, was finalized. Implemented by CMS as a result of this significant change to payment is a 4-year transition beginning in CY 2008.

Over the span of 4 years the ASC revised payment rates will be based on a blend of CY 2007 ASC payment rates and the revised ASC payment rates at 75/25 in CY 2008, 50/50 in CY 2009, and 25/75 in CY 2010, with payment at 100% of the revised ASC payment rates in 2011.

Also, payment to ASCS under the revised ASC payment system for procedures commonly performed in a physician's office will be made at the lesser of the ASC rate or the Medicare Physician Fee Schedule (MPFS) non-facility practice expense amount beginning in 2008. ASC payments will be frozen until 2009 and beginning with 2010 the ASC conversion factor will be updated by the Consumer Price Index for Urban Consumers (CPI-U).