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RESOURCES
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Medicare Hospital Outpatient Prospective Payment System (OPPS)

OPPS Changes for 2009

Most separately payable Medicare Part B-covered drugs that are administered by physicians in the hospital outpatient setting will be reimbursed at a rate of ASP plus 4 percent in 2009.

That was one of several provisions finalized in the Medicare Hospital Outpatient Prospective Payment System (OPPS) for fiscal year 2009. The changes are effective from January 1, 2009 to December 31, 2009.

CMS updated the conversion factor for the OPPS in 2009 to $66.059, resulting in a market basket increase update factor of 3.6 percent over 2008. However, hospitals that fail to meet quality-reporting requirements under the Hospital Outpatient Quality Data Reporting Program (HOP QDRP) will have a reduced conversion factor of $64.784, meaning that they will be eligible for a Medicare payment increase of just 1.6 percent over 2008 level.1
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| 1Federal Register, Vol. 73 No. 223, Tuesday, November 18, 2008, Rules and Regulations.
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