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CMS pushes off-campus provider-based OPPS claim edits implementation to October — 3 insights

CMS delayed implementing changes to the Outpatient Prospective Payment System requiring health systems to list addresses for care delivered at off-campus provider-based departments, Revcycle Intelligence reports.

What you should know:

1. CMS was expected to implement the changes in July but pushed the implementation to October.

2. CMS is analyzing data from a third study of the changes after some stakeholder feedback. CMS said there was no major issue with the testing.

3. Once CMS implements the October 2019 quarterly release, health systems will have to include the exact location of pertinent departments on form CMS-855A and enter the facilities into the Provider Enrollment, Chain and Ownership System. If the address is not exact, the claim will be returned and could be denied, Revcycle Intelligence reports.

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