Centers for Medicare & Medicaid Services (CMS) recently published the final rule regarding reimbursement for services provided at off-campus, provider-based departments (PBDs). The rule, which became effective January 1, 2017, eliminates payment at outpatient prospective payment system (OPPS) rates for services furnished in off-campus PBDs unless the PBD:
- Serves as a dedicated emergency department;
- Is located within 250 yards of the main hospital or a remote location of the hospital; or
- Had been billing covered outpatient services provided at the location under OPPS prior to November 2, 2015. This includes off-campus PBDs that furnished any covered service prior to November 2 but did not bill for the service until after November 2. More
