Hospital Outpatient Regulations and Notices

Medicare Program: Changes to the Hospital Outpatient Prospective Payment System and CY 2009 Payment Rates; Changes to the Ambulatory Surgical Center Payment System and CY 2009 Payment Rates; Hospital Conditions of Participation: Requirements for Approval and Re-Approval of Transplant Centers to Perform Organ Transplants--Clarification of Provider and Supplier Termination Policy
Medicare and Medicaid Programs: Changes to the Ambulatory Surgical Center Conditions for Coverage

SUMMARY: This final rule with comment period, in part, revises the Medicare hospital outpatient prospective payment system to implement applicable statutory requirements and changes arising from our continuing experience with this system, and to implement a number of changes made by the Medicare Improvement for Patients and Providers Act of 2008. In this final rule with comment period, we describe the changes to the amounts and factors used to determine the payment rates for Medicare hospital outpatient services paid under the prospective payment system. These changes are applicable to services furnished on or after January 1, 2009.

In addition, this final rule with comment period updates the revised Medicare ambulatory surgical center (ASC) payment system to implement applicable statutory requirements and changes arising from our continuing experience with this system. In this final rule with comment period, we set forth the applicable relative payment weights and amounts for services furnished in ASCs, specific HCPCS codes to which these changes apply, and other pertinent ratesetting information for the CY 2009 ASC payment system. These changes are applicable to services furnished on or after January 1, 2009.

Downloads
Median Files [ZIP 547KB] Addenda [ZIP 1.05MB] 2009 OPPS Facility-Specific Impacts [ZIP 610KB] Blood Revenue Code Cost to Charge Ratios [ZIP 161KB] FY 2009 IPPS Wage Index Tables 4A, 4B, 4C, 4F, 4J, 9A, 9B, 9C [ZIP, 439KB] Out-Migration Wage Adjustment for CY 2009 [ZIP, 35KB] 2009 OPPS Claims Accounting [PDF, 75KB] 2009 OPPS Without Cost or With Credit Device Information [ZIP, 28KB] 2009 OPPS Offset Amounts by APC [ZIP, 36KB] 2009 OPPS/ASC Preamble Tables [ZIP, 105KB] ASC Related Files Addendum AA, BB, DD1, DD2, and EE [ZIP, 317KB] FY 2009 Pre-reclass Wage Index for Use in Calculating Payments Effective for Services Furnished Beginning January 1, 2009 Under the Revised ASC Payment System [ZIP, 28KB] ASC Fully Implemented weights file [ZIP, 234KB] 2009 ASC Without Cost or With Credit Device Information [ZIP, 27KB]
Related Links Inside CMS
CMS-1404-FC - Final Changes to the ASC Payment System and CY 2009 Payment Rates 2009 Annual Policy Files OPPS Identifiable Data Set OPPS Limited Data Set
Related Links Outside CMS
CMS-1404-FC - PDF Version [PDF, 57MB] CMS-1404-FC - Text Version [TXT, 2.34MB]