January 2021 Update of the Hospital OPPS

MLN Matters Number: MM12120
Related CR Release Date: December 31, 2020
Related CR Transmittal Number: R10541CP and R10541BP
Related Change Request (CR) Number: 12120
Effective Date: January 1, 2021
Implementation Date: January 4, 2021

CR 12120 describes changes to and billing instructions for various payment policies implemented in the January 2021 Outpatient Prospective Payment System (OPPS) update. The January 2021 Integrated Outpatient Code Editor (I/OCE) will reflect the HCPCS, Ambulatory Payment Classification (APC), HCPCS Modifier, and Revenue Code additions, changes, and deletions that CR 12120 discusses. The January 2021 revisions to I/OCE data files, instructions, and specifications are provided in CR 112114. When available, you can review a related article, MM12114, at https://www.cms.gov/files/document/mm12114.pdf.

CR 12120 also makes a change to the Chapter 6 of the Medicare Benefit Policy Manual related to Coverage of Outpatient Therapeutic Services Incident to a Physician’s Service Furnished on or after January 1, 2021. The revised portion of the manual is part of CR 12120.

Make sure that your billing staffs are aware of these changes.

View the complete CMS Medicare Learning Network (MLN) Matters (MM)12120.


            Last Updated Wed, 06 Jan 2021 15:30:44 +0000