OPPS & ASC Fee Schedules

The Centers for Medicare and Medicaid Services (CMS) uses the OPPS (Outpatient Prospective Payment System) and ASC (Ambulatory Surgical Center) Fee Schedules to determine reimbursement rates for healthcare providers for certain procedures performed on an outpatient basis.

The OPPS Fee Schedule applies to hospital outpatient departments and some freestanding clinics, while the ASC Fee Schedule applies to ASCs (ambulatory surgical centers).

These fee schedules are important for healthcare providers to understand, as they directly impact the reimbursement they receive for services provided to Medicare and Medicaid patients. Here's how you can access and use the OPPS & ASC Fee Schedules:

1. Accessing the Fee Schedules

You can find the OPPS & ASC Fee Schedules on the code details page under the "Compliance Tools" section. This page is available to all users with a Complete Coder subscription.

2. Changing the Medicare Carrier/Locality

You have the option to change the Medicare Carrier/Locality on the code details page and make it your default setting. This allows you to view the fee schedules specific to your location, ensuring accurate reimbursement rates for your services.

3. Using the Fee Schedule Widget

You can also access the OPPS & ASC Fee Schedule widget on the homepage. This widget allows you to quickly search for specific codes and view the corresponding reimbursement rates.

4. Making Changes to Default Settings

If you have changed your default Medicare Carrier/Locality and want to revert back to the original settings, you can do so by clicking on the "Reset to Default" button on the code details page.

In Conclusion

The OPPS & ASC Fee Schedules are important tools for healthcare providers to ensure accurate reimbursement for services provided to Medicare and Medicaid patients. By accessing and utilizing these fee schedules, you can stay informed and up-to-date on the latest reimbursement rates for your services.

Remember, the OPPS & ASC Fee Schedules are available with an annual Complete Coder subscription. Subscribe today to stay on top of the latest reimbursement rates and coding updates.