CMS Releases 2016 Final Rule on the Hospital Outpatient Prospective Payment System

On October 30, 2015, the Centers for Medicare and Medicaid Services (CMS) released its final regulations setting payment rates for physician and hospital outpatient services for 2016. The Hospital Outpatient Final Rule chart shows the Medicare hospital outpatient payment rates for 2016 for epilepsy center services. CMS finalized its proposal to consolidate the hospital facility payment for all non-imaging diagnostic tests under four new categories: Level 1 – 4 Diagnostic Tests and Related Services. The impact on payment varies by CPT code with significant facility fee reductions for some EEG and MEG services. This restructuring of hospital outpatient payments has no impact on the payment for the professional component of the service, which is paid for separately under Medicare’s Physician Fee Schedule.

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