Bulletin Details

3926: October 6, 2006

WSHA Analysis of Medicare Outpatient Payment Rates

The Centers for Medicare & Medicaid Services (CMS) recently released their proposed rule for the outpatient prospective payment system for fiscal year 2007.  CMS made several significant changes to its payment system, which include expanding the number of procedures that will be allowed at Ambulatory Surgical Centers.  CMS also established new codes for emergency department and clinic services.

The enclosures to this bulletin provide an analysis of the impact of these changes on your hospital.  This information is part of an extensive series of new Medicare reimbursement analysis tools.  This series is made possible by a new arrangement between WSHA's Health Information Program and the Health and Hospital Association of New York State.  If you have questions or would like to discuss this analysis, please contact Will Callicoat at willc@wsha.org or (206) 216-2533.


  1. Outpatient Prospective Payment System (OPPS) Analysis of Proposed Change in Clinic and Emergency Department Visit APCs 

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  2. Outpatient Prospective Payment System (OPPS) Analysis of Hospital Financial Exposure Related to the Proposed Ambulatory Surgery Center (ASC) Payment Expansion 

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