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CMS takes initial steps toward paying for encounters, not services

Ambulatory Surgery Reimbursement Update, July 24, 2007

CMS is "proposing to view a service, in some cases, as not just the diagnostic or treatment modality identified by one individual HCPCS code but as the totality of care provided in a hospital outpatient encounter that would be reported with two or more HCPCS codes for component services," according to the 2008 OPPS proposed rule, released Monday.

CMS proposed to package the payment for HCPCS codes describing the dependent items and services in the following seven categories into the payment for the independent services with which they are furnished:

  • Guidance services
  • Intraoperative services
  • Imaging supervision and interpretation services
  • Diagnostic radiopharmaceuticals
  • Contrast media
  • Observation services

CMS is proposing to roll the payment for these services into the main procedure/visit code associated with the patient's visit.

You can read the proposed rule in its entirety by clicking here.

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