CY 2003
Hospital Outpatient Prospective Payment System

Changes to the Hospital Outpatient Prospective Payment System for
Calendar Year 2003.

CMS-1206-FC and CMS-1179-F:    - Final Rule: Medicare Program; Changes to the Hospital Outpatient Prospective Payment System and Calendar Year 2003 Payment Rates; and Changes to Payment Suspension for Unfiled Cost Reports (CMS-1206-FC and CMS-1179-F).

Fact Sheets (CMS-1206-FC and CMS-1179-F):

• Outpatient Prospective Payment System (OPPS) Fact Sheet (ZIP 10KB, 49KB decompressed)
• Payment for Epogen, Procrit, and Aranesp under OPPS (ZIP 8KB, 40KB decompressed)
• OPPS Briefing Chart 1 (ZIP 73KB, 210KB decompressed)
• OPPS Briefing Chart 2 Outpatient PPS Expenditures (ZIP 408KB, 447KB decompressed)

Supporting Data Files for CMS-1206-FC and CMS-1179-F:

• Median Costs for Hospital Outpatient Services (ZIP 198KB, 545KB decompressed)
  This Excel file displays median costs, by HCPCS code, for services that we are paying under the hospital outpatient prospective payment system in calendar year 2003. For each HCPCS code, the APC, the status indicator, and the 2003 APC payment is shown. The data are based on claims for hospital outpatient services provided between January 1, 2001 and December 31, 2001.
• Addendum A (ZIP 38KB, 110KB decompressed)
  This Excel file lists, in APC order, the name, payment status indicator, relative weight, payment rate and copayment amount for each ambulatory payment classification (APC) as printed in Addendum A in the Federal Register on November 1, 2002.
• Addendum B(ZIP 371KB, 1.4MB decompressed)
  This Excel file lists, in HCPCS code order, the HCPCS codes with payment status indicators, APCs, relative weights, payment rates and copayment amounts, as printed in Addendum B in the Federal Register on November 1, 2002.
• Addendum C (ZIP 148KB, 554KB decompressed)
  This Excel file lists, in APC order, the HCPCS codes in each APC with the payment status indicator, relative weight, payment rate and copayment amount for each APC, consistent with the final rule printed in the Federal Register on November 1, 2002.
• Addendum D (ZIP 4KB, 25KB decompressed)
  This Excel file lists Payment Status Indicators for the Hospital Outpatient Prospective Payment System
• Addendum D1 (ZIP 3KB, 20KB decompressed)
  This Excel file lists condition codes for the Hospital Outpatient Prospective Payment System
• Addendum E (ZIP 39KB, 160KB decompressed)
  This Excel file lists CPT Codes That Would Be Paid Only As Inpatient Procedures.
• Addendum H (ZIP 65KB, 196KB decompressed)
  Wage Index for Urban Areas .
• Addendum I (ZIP 5KB, 32KB decompressed)
  Wage Index for Rural Areas .
• Addendum J (ZIP 11KB, 72KB decompressed)
  Wage Index for Hospitals that are Reclassified .
• Hospital-Specific Impacts
  Three files that were used for the impact analysis contained in the November 1, 2002 final rule:
  1. Provider-specific data (ZIP 350KB, 931KB decompressed)
  2. File layout(ZIP 7KB, 38KB decompressed)
  3. Payment calculation explanation(ZIP 5KB, 25KB decompressed)