The Centers for Medicare and Medicaid Services (CMS) issued the 2017 Physician Fee Schedule (PFS) final rule, which improves payments for chronic care management and behavioral health, and finalizes the proposal to expand the Diabetes Prevention Program model to eligible Medicare beneficiaries starting Jan. 1, 2018. 

CMS also finalized updated payment rates and policy changes in the Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System for 2017. OPPS payments will increase by an estimated 1.7 percent and ASC rates by approximately 1.9 percent in 2017. 

Among the policy changes, CMS is removing the pain management dimension of the HCAHPS Survey with regard to the Value-Based Purchasing program “to eliminate any financial pressure clinicians may feel to overprescribe medications.” 

Other policy changes pertain to site-neutral payment provisions. Hospital off-campus facilities that began billing Medicare on or after Nov. 2, 2015, will no longer be reimbursed under the OPPS, although CMS is permitting certain exceptions. The agency issued an interim final rule to establish new payment rates under the PFS for 2017 for certain off-campus provider-based departments so that hospitals can be paid for services that are no longer being paid under the OPPS.

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