Medicare Compliance & Reimbursement

Pass through payments escape across-the-board cuts. 

Hospitals will collect 4.5 percent more on average from Medicare for outpatient services in 2004.

That's according to the Centers for Medicare & Medicaid Services final outpatient prospective payment system rule, slated for publication in the Nov. 7 Federal Register. What's more, CMS won't be imposing an across-the-board reduction on pass-through payments for drugs, biologicals and devices, as it did - to much outcry - last year.

According to CMS, payments for clinic visits, emergency department visits and preventive care will all go up. The rule also sets two thresholds for outlier payments under the OPPS: 2.60 times the ambulatory payment classification rate for most facilities; 3.65 percent for community mental health centers.