2009-11-01
The Centers for Medicare and Medicaid Services (CMS)
released the final 2010 Hospital Outpatient
Prospective Payment System (HOPPS)/Ambulatory Surgical Center (ASC) rule.
The rule announced that most hospitals will receive an inflation update of 2.1
percent in their payment rates for services furnished to Medicare beneficiaries in outpatient departments. As
required by Medicare law, CMS will reduce the update by 2.0 percentage points
for hospitals that did not participate in quality data reporting for outpatient
services or did not report the quality data successfully, resulting in a 0.1
percent update for those hospitals.
CMS agreed
with ASH’s comments to the 2010 proposed HOPPS rule
that the allogeneic stem cell transplants described by Current Procedural Terminology (CPT) codes 38240 and
38242 can be safely and appropriately performed on some Medicare beneficiaries
on an outpatient basis. As a result, it
did not finalize a proposal that would have limited a provider's ability to
report these services on an outpatient basis under the HOPPS payment system.
Unfortunately,
CMS did finalize a proposal to no longer allow separate payment for CPT code
38205 - Harvest, allogenic stem cells, in the hospital outpatient
environment. In the final rule, code
38205 would be considered a bundled service and not separately paid under the
HOPPS payment system. ASH had urged CMS
to continue to allow separate payment for this service in their comments on the
proposed 2010 HOPPS regulations.
ASH will provide further
details and analysis after evaluating the impact of these revisions.
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