January 2020 Update of the Hospital Outpatient …

MLN Matters MM11605 Related CR 11605 Page 1 of 23 January 2020 Update of the Hospital Outpatient Prospective Payment System (OPPS) MLN Matters Number: MM11605 Revised Related CR Release Date: February 4, 2020 Related Transmittal Number: R4513CP & R267BP Related Change Request (CR) Number: 11605 effective Date: January 1, 2020 Implementation Date: January 6, 2020 Note: We revised this article on February 4, 2020, due to an updated CR 11605. To reflect the updated CR in the article, we added Section (Radiopharmaceuticals with Pass-Through Status as a Result of Division N, Title I, Subtitle A, Section 107(a) of the Further Consolidated Appropriations Act of 2020 (Public Law 116-94)) and Section 19 Extravascular Implantable Cardioverter Defibrillator (EV ICD). We renumbered existing Sections through and changed Section 19 (Coverage Determinations) to Section 20. We also added Table 11 (Radiopharmaceuticals Receiving Pass-Through Status in Accordance with Public Law 116-94) and Table 14 (Extravascular Implantable Cardioverter Defibrillator (EV ICD) effective January 1, 2020).

Feb 04, 2020 · Two New Comprehensive APCs (C-APCs) Effective January 1, 2020. Comprehensive APCs provide a single payment for a primary service, and payment for all adjunctive services reported on the same claim is packaged into payment for the primary service. With a few exceptions, all other services reported on a hospital outpatient claim in

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