Proposed Rule to Ensure Site-Neutral Payment for Clinic Visits Will Save Patients $150 Million, CMS Says

August 1, 2018 | Strategic Insights for Health System


​The Centers for Medicare and Medicaid Services (CMS) announced on July 25, 2018, a proposed rule that would move toward site-neutral payments for clinic visits. The proposed rule, which can be downloaded from the Federal Register, will be part of the calendar year 2019 Hospital Outpatient Prospective Payment System (OPPS) and the Ambulatory Surgical Center (ASC) Payment System. Clinic visits are the most common service billed under the OPPS, CMS said, and CMS currently pays more for the same type of visit in a hospital outpatient setting than in a physician office. If finalized, CMS said, the rule could save patients about $150 million in copayments for clinic visits.

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