Health Information Management

News: House proposal aims to create new surgical payment method

CDI Strategies, August 20, 2015

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A new proposal introduced by the House Ways and Means Committee aims to match payment rates and methods for surgical procedures regardless of whether they are performed on an inpatient or outpatient basis, according a one-page brief on the topic from the committee.

The brief cites a June Medicare Payment Advisory Commission (MedPAC) study which identified top 10 surgical MS-DRGs and found that Medicare paid roughly $4,240 more, on average, for an inpatient stay than for a comparable outpatient surgery.

The proposal would require HHS to create a new payment system for at least 10 surgical Medicare Severity Diagnosis-Related Groups, which would serve as a guide to connect inpatient and outpatient coding and payment systems for hospitals.

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