CY 2020 Hospital Outpatient Prospective Payment System Updates

AHIMA February 1, 2020
Melissa Koehler, RHIA, CHDA, CDIP, CCS, CCS-P, CCDS

Just as the new year brings in resolutions, procedural code updates, and an uptick in gym memberships, the same is true for updates to the Hospital Outpatient Prospective Payment System (OPPS). The calendar year (CY) 2020 final rule for the OPPS and ambulatory surgical center (ASC) payment systems became effective January 1, 2020. This article presents a synopsis of the changes.

Payment Rates

The CY 2020 final rule included a 2.6 percent increase for OPPS payment rates based on the projected 3.0 percent hospital market basket increase minus a 0.4 percentage point adjustment for multi-factor productivity (MFP).

The CY 2020 conversion factor for ASC payment rates was also increased based on the CY 2019 proposal to apply the hospital market...

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