Decoding Device Billing Under OPPS For Hospitals
Medicare is one of the healthcare industry’s fastest-growing federal health-insurance programs. With so many patients dependent on Medicare for outpatient services, hospital expenditures are constantly increasing. To cover so many Medicare patients, this causes a financial imbalance in the hospital budget. Keeping this in mind, CMS developed the Outpatient Prospective Payment System (OPPS) to monitor outpatient service expenses better. This keeps hospitals from running into financial difficulties while delivering outpatient services to thousands of Medicare beneficiaries. Purpose of Decoding Device Billing: The OPPS permits CMS to pay hospitals an agreed-upon sum for Medicare outpatient services. This approach dramatically improves CMS’s ability to foresee and manage programs. It should be noted that the OPPS system is based on the Ambulatory Patient Classification (APC) methodology. To ensure the success of the OPPS, CMS allocates HCPCS codes to APC, which are changed annually. ...