Final Rule Regarding Off-Campus Provider-Based Departments

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


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