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Payment Rates under the Medicare Physician Fee Schedule for Nonexcepted Items and Services Furnished by Nonexcepted Off-Campus Provider-Based Departments of a Hospital In CY 2017, CMS finalized the MPFS as the applicable payment system for certain items and services furnished by certain off-campus hospital outpatient provider-based department.
For CY 2018, CMS is finalizing a reduction in the current MPFS payment rates for these items and services by 20 percent.
For CY 2018, CMS determined the MPFS conversion factor to be .99.
This update reflects the 0.50 percent update established under the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015, reduced by 0.09 percent, due to the misvalued code target recapture amount, required under the Achieving a Better Life Experience (ABLE) Act of 2014.
CMS is finalizing a change to the current policy that requires reporting of 9 measures across 3 National Quality Strategy domains to only require reporting of 6 measures.
CMS is finalizing their proposal to use the Level II HCPCS Modifiers found in Table 1 (below) as the patient relationship codes.
AHA Rural Hospital Leadership Award The AHA Rural Hospital Leadership Award is sponsored by the Section for Small or Rural Hospitals.
The award recognizes small or rural hospital chief executives and administrators who have achieved improvements in local health delivery and health status through their leadership and direction.
CMS is also finalizing their proposal that Medicare claims submitted for items and services furnished by a physician or applicable practitioner on or after January 1, 2018.
For 2018, an applicable practitioner is defined as a physician assistant, nurse practitioner, clinical nurse specialist, and a certified registered nurse anesthetist.
The Secretary of HHS has the authority to expand the list of applicable practitioners to include other providers, such as audiologists, in 2019.
CMS did not finalize its proposal to use updated premium data in computing the professional liability insurance relative values.
CMS has stated that they will work to address the limitations with the premium data before updating this information in 2020.