CMS releases final rules on doc fee schedule, outpatient and home health payments

The CMS on Tuesday issued final rules that update payment rates for its physician fee schedule (PDF), and also updated payments for hospital outpatient services (PDF), ambulatory surgical centers, and home health payments (PDF). The rules take effect Jan. 1, 2011, although the CMS said it will accept comments if they are received no later than Jan. 3.

In the rule pertaining to outpatient and ambulatory services, the CMS proposed to establish a limited set of non-surgical, extended-duration services for which the CMS would allow direct supervision initially and then allow for general supervision at the discretion of the physician or non-physician practitioner. These services—16 in all—include direct admission of a patient for hospital observation care; intravenous infusions for therapy, prophylaxis, or diagnosis; and subcutaneous infusions for therapy or prophylaxis.

For the home health segment, CMS said it will apply a 3.79% reduction to the home-health prospective payment rates in 2011, as the agency outlined in its proposed rule on July 23.

“In response to comments that we received on our case-mix model and its measurement of real case-mix, we will further study the concerns raised and are not finalizing the proposed 3.79% reduction to the HH PPS for CY (calendar year) 2012 at this time,” the rule noted. The CMS said it will address any reductions to the 2012 calendar year in next year's rulemaking.