This policy would result in lower copayments for beneficiaries and savings for the Medicare program in an estimated amount of $380 million for 2019, CMS said. The payment change in 2018 is saving beneficiaries an estimated $320 million in out-of-pocket payments, CMS said.Ĭlinic visits are the most common service billed under the outpatient prospective payment system.Ĭurrently, CMS and beneficiaries often pay more for the same type of clinic visit in the hospital outpatient setting than in the physician office setting. The program allows 340B hospitals to buy outpatient drugs at lower cost. In 2018, CMS implemented a payment policy on drugs acquired through the 340B program that were administered at hospital outpatient departments. ![]() In addition, for 2019, CMS is expanding its 340B policy by extending the payment change to additional off-campus provider-based hospital outpatient departments that are paid under the physician fee schedule. This change will be phased in over two years. ![]() The Centers for Medicare and Medicaid Services has finalized site neutral payments in the hospital outpatient prospective payment system and ambulatory surgical center payment system rule.ĬMS is using site neutral payments to level the playing field between what physician offices and hospital outpatient departments are paid for certain clinical visits.
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