CMS to reprocess excepted off-campus provider-based outpatient claims following court ruling -

CMS says it’ll begin reprocessing claims for outpatient clinic visit services provided at excepted off-campus provider-based departments (PBDs) during the 2019 calendar year. It’s in response to a U.S. Court of Appeals decision which overturned a lower court’s decision that a rule adopted by the CMS in 2018 which cut payments for some services performed at outpatients clinics was invalid. The reversal confirmed the site-neutral payment reduction, in which hospitals will be paid the same rate as non-excepted off-campus provider-based departments for clinic visits. CMS says it’ll begin reprocessing claims beginning July 1.