CMS Releases Projected Reimbursement Rates For 2015


The Center for Medicare & Medicaid Services released its projected reimbursement rates for 2015. A report from Moody’s gives crucial information about how the change in rates will affect physicians. Some main points are:

1. The 2.1% increase in the payment rate through Medicare’s Outpatient Prospective Payment System would be a “modest credit positive” for healthcare providers. According to Moody’s, outpatient revenue is becoming a larger proportion of a hospital’s total revenue.

2. The CMS proposed the “continuation of a 2 percent pay cut for hospitals that don’t meet outpatient quality reporting requirements.” There is also a provision to “to start collecting data on services provided in off-campus provider-based departments”, which Medicare could use to change “how it reimburses hospitals that have been changing the billing of acquired physician practices to a hospital outpatient department under the OPPS.”

3. There will also be modifications to the OPPS regarding comprehensive-ambulatory payment classifications. These were originally made to “pay for high-cost device-dependent services using a single payment for a hospital stay.”

4. There will be an update to the Medicare Physician Fee Schedule, with the final figure being issued in November.

5. Moody’s expects Congress will reenact delays to the sustainable growth rate cuts. The sustainable growth rate cuts were originally created to “control growth in Medicare spending on physicians’ services.”

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