On September 9, 2024, APA Services submitted a comment letter to the Centers for Medicare and Medicaid Services in response to the annual Hospital Outpatient Prospective Payment System (OPPS) proposed rule (PDF, 1223KB)opens in new window. The OPPS rule governs coverage and payment policies for services provided in hospitals, community mental health centers, and ambulatory surgical centers.
If finalized as proposed, these rules would have a positive impact on access to care through outpatient programs in these settings. First, the proposed rules include an increase in reimbursement for Intensive Outpatient Programs and Partial Hospitalization Programs. Second, for behavioral health clinics, the proposed rule would allow state Medicaid programs to waive the general rule that most services must be provided within the facility receiving payments. The proposed rule also outlines a means of enabling coverage and reimbursement of digital therapeutics devices, and APA Services offered technical comments on the rule.
For more information, contact Andrew Strickland.