Heart of Health Policy | HOPPS Highlights

On July 25, the Centers for Medicare and Medicaid Services (CMS) released proposed changes to the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System for 2019.

Highlights from the proposed rule include:

  • Moving toward site neutral payments for clinic visits offered under OPPS, potentially lowering the average OPPS payment by $70, aligning OPPS payment with the Physician Fee Schedule payment amount.
  • Adding 12 cardiac catheterization procedures to the list of covered procedures that can be performed in an ASC.
  • Updating ambulatory payment classifications (APCs) for endovascular procedures, particularly those using drug-coated balloons.
  • Updating the APC structure for imaging procedures, with and without contrast, an ongoing area of review for the ACC and other societies in recent years.

Keywords: ACC Publications, Cardiology Magazine, Health Policy, Centers for Medicare and Medicaid Services (U.S.), Outpatients, Medicare, Fee Schedules, Medicaid, Health Expenditures, Prospective Payment System, Ambulatory Care, Endovascular Procedures, Cardiac Catheterization


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