Hospital Outpatient Regulations and Notices

Hospital Outpatient Prospective Payment System and CY 2007 Payment Rates; CY 2007 Update to the Ambulatory Surgical Center Covered Procedures List

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CMS-1506-FC [PDF, 5.11MB] Median Costs for Hospital Outpatient Services, by HCPCS code - This Excel file displays median costs, by HCPCS code, for services payable under the Hospital OPPS in calendar year 2007. The data are based on claims for hospital outpatient services provided January 1, 2005 through December 31, 2005. [ZIP, 263KB] This document has been revised to correct a minor file conversion error. 4/13/07 Median Costs for Hospital Outpatient Services, by ambulatory payment classification (APC) group - This Excel file displays median costs, by APC group, for services payable under the OPPS in calendar year 2007. The data are based on claims for hospital outpatient services provided January 1, 2005 through December 31, 2005. [ZIP, 39KB] Median Costs for Drugs, Biologicals, and Radiopharmaceuticals - This Excel file displays cost data, in HCPCS code order, for drugs, biologicals, and radiopharmaceuticals that are packaged or separately payable under the OPPS in calendar year 2007. The data are based on claims for hospital outpatient services provided January 1, 2005 through December 31, 2005. [ZIP, 55KB] Addendum A - This Excel file lists, in APC order, the name, payment status indicator, relative weight, payment rate, and copayment amount(s) for the 2007 APC groups. [ZIP, 47KB] Addendum B - This Excel file lists payment information by HCPCS code for the 2007 OPPS. [ZIP, 416KB] Addendum C - This Excel file groups HCPCS codes payable under the 2007 OPPS by APC. [ZIP, 167KB] Addendum D1 - This table lists the 2007 OPPS payment status indicators and what they signify. [PDF, 95KB] Addendum D2 - This table describes comment indicators assigned to new and deleted HCPCS codes in Addendum B. [PDF, 11KB] Addendum E - This Excel file lists HCPCS codes that would only be payable as inpatient procedures (inpatient list). [ZIP, 51KB] FY2007 IPPS Wage Index, Table 4A: (formerly Addendum H) Table 4A-1 [ZIP, 51KB] Table 4A-2 [ZIP, 4KB] FY2007 IPPS Wage Index, Table 4B: (formerly Addendum I) Table 4B-1 [ZIP, 5KB] Table 4B-2 [ZIP, 5KB] FY2007 IPPS Wage Index, Table 4C: (formerly Addendum J) Table 4C-1 [ZIP, 14KB] Table 4C-2 [ZIP, 3KB] FY2007 IPPS Wage Index, Table 4F: (formerly Addendum K) [ZIP, 3KB] Addendum L - Out-Migration Wage Adjustment for CY 2007 [ZIP, 19KB] FY2007 IPPS Wage Index, Table 9A: (formerly Addendum M) [ZIP, 17KB] FY2007 IPPS Wage Index, Table 9B: (formerly Addendum N) [ZIP, 5KB] FY2007 IPPS Wage Index, Table 9C: (formerly Addendum O) [ZIP, 3KB] 2007 OPPS Hospital-Specific Impacts - Provider-specific data [ZIP, 334KB] 2007 OPPS Hospital-Specific Impacts - File layout [PDF, 27KB] 2007 OPPS Claims Accounting - Updated 11/02/06 [PDF, 53KB] 2007 OPPS Without Cost or With Credit Device Information [ZIP, 6KB] Blood Revenue Code Cost to Charge Ratios (CCRs) File Layout [PDF, 19KB] Blood Revenue Code Cost to Charge Ratios (CCRs) [ZIP, 119KB] 2007 OPPS Rural Regression Analysis Files - Rural Regression Data - Unchanged from 2006 [PDF, 222KB] 2007 OPPS Rural Regression Analysis Files - Rural Regression Analysis Layout - Unchanged from 2006 [PDF, 11KB] 2007 OPPS Preamble Tables [ZIP, 69KB] DRAFT CMS-Revised AHA/AHIMA Visit Guidelines for the OPPS: Technical Excerpts from Iowa Foundation for Medical Care Phase 1 Analysis Report [PDF 205KB]
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