The Centers for
Medicare and Medicaid Services (CMS) has published a final rule
correcting the 2002 hospital outpatient prospective payment system
(PPS) rates. Implementation of the 2002 outpatient PPS, which was
originally scheduled from January 1, 2002, has been delayed pending
these corrections. In general, these corrections, which were
published in the March 1, 2002 Federal Register, mean higher
payments in 2002 than were originally planned, although the rates
still tend to be lower than 2001 rates.
In a November
30, 2001, final rule, CMS incorrectly assigned certain pass-through
devices to several ambulatory payment classifications (APCs), causing
the payments for some APCs to be set inaccurately. The corrections
included in the new final rule significantly increase payment for 13
APCs, covering procedures such as positron evaluations, and placement
of certain intracoronary stents. For all other APCs, rates remained
the same or were slightly increased.
The new final
rule still includes the 75 percent fold-in of new-technology
transitional pass-through payments into the base rates for relevant
APCs. However, CMS has dropped the pro rata reduction on
pass-through payments from 68.9 percent to 63.6 percent for services
not affected by the fold-in.