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CHA Issues Summaries of CY 2021 OPPS and PFS Proposed Rules

For CEOs, CFOs, government relations, quality & patient safety and finance & reimbursement staff

CHA has issued detailed summaries, prepared by Health Policy Alternatives, of the Centers for Medicare & Medicaid Services (CMS) calendar year (CY) 2021 outpatient prospective payment system (OPPS) and physician fee schedule (PFS) proposed rules. CHA will also provide an overview of the proposed rules in an on-demand webinar, available in mid-September. Comments on both proposed rules are due Oct. 5.  

In addition to annual payment and policy updates, the OPPS proposed rule summary details CMS’ proposed reductions to the payment rate for certain drugs purchased under the 340B drug savings program, as well as the proposed elimination of the inpatient-only list over three years, and significant changes to the hospital star ratings methodology. 

The PFS proposed rule summary describes proposed modifications to office and outpatient E/M visit coding and documentation policies to be effective for CY 2021, policies to expand telehealth services beyond the COVID-19 public health emergency, and clinical laboratory reporting requirements – including for hospital outreach laboratories – delayed until 2022.