In OPPS/ASC Final rule, CMS fully phases in Site-Neutral Clinic Visit Cuts and Maintains 340B Drug Cuts

November 12, 2019

The 2020 OPPS APC final rule released by the Centers for Medicare and Medicaid Services (CMS) last Friday continues to cuts to hospital payments that were determined unlawful under recent court decisions. The rule finishes phasing in the site-neutral reduction to 40 percent of the regular OPPS rate for clinic visits provided in grandfathered off-campus departments for CY 2020, despite a U.S. District Court’s recent decision that CMS exceeded its authority in applying these cuts. CMS reduced payment for these clinics to 70 percent of the regular OPPS rate for 2019. Under the rule, CMS also continues its cuts to drugs purchased under the 340B drug savings program despite a separate court decision in favor of the hospitals. WSHA’s comments on the proposed rule submitted in September called on CMS to restore both the site neutral and 340B cuts to hospitals.

The rule does not address the requirement in the proposed rule that hospitals disclose payer-specific negotiated rates. CMS indicated a final rule on those provisions would be released separately.

In addition, CMS finalized a policy to change the minimum required level of supervision from direct supervision to general supervision for all hospital outpatient therapeutic services provided by hospitals and critical access hospitals and finalized changes to the wage index. WSHA will provide more specific information and analyses of hospital-specific impacts to finance staff at member hospitals when the reports are available. (Andrew Busz,


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