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November 2, 2018

CMS Issues 2018 OPPS Final Rule

On November 2, 2018, CMS issued its Hospital Outpatient and Prospective Payment System (OPPS) final rule. Of particular note, the agency finalized the proposal to extend the reduced payment rate provided under Section 603 of the Bipartisan Budget Act of 2015 (BBA) to clinic visits (code G0463) at grandfathered off-campus provider based clinics, phasing it in over two years. They also finalized the proposal to extend the 28.5 percent cut payments for separately payable drugs purchased through 340B to “nonexcepted” off campus clinics (i.e. clinics not grandfathered under the BBA).