Hospital Outpatient Prospective Payment System (OPPS) and Medicare Physician Fee Schedule (MPFS) 2022 Updates

Wednesday, December 15, 2021
1 hour

Important changes have been proposed for 2022 impacting hospital outpatient billing and coding. Updates include changes to price transparency penalties for non-compliance, reinstatement of the inpatient-only list, removal of some ASC-covered procedures, continuation of the 340B and other site neutral reductions, reduction of the conversion factor, allowance of some audio-only telehealth mental health services, finalization of changes to split/shared E/M reporting, and PT/OT discounted payment for assistants and direct payment for certain PA provided services. This presentation will provide detail on the final rule decisions on these issues and more.

Learning objectives:

  • Review the changes in the OPPS and some of the MPFS final rules
  • Highlight key procedural coding and reimbursement changes
  • Cover changes that could affect operational changes
  • Share when these changes will be implemented
  • Identify what the changes will mean for hospitals

Richard R. Cooley, BA, CCS

Epoch Health Solutions, LLC

Richard has more than twenty years in healthcare consulting. He has developed an expertise in hospital outpatient and inpatient coding, including professional split billing and E/M coding, admission criteria, reimbursement and compliance, and charge master reviews. His areas of expertise include Medicare reimbursement for the Medicare Outpatient Prospective Payment System (OPPS), Medicaid Ambulatory Payment Groups (APGs), as well as commercial payers and professional reimbursement. He is a certified coder with AHIMA (CCS). Richard earned his bachelor’s from Hobart College.

Veronica R. Ziac, MBA

Epoch Health Solutions, LLC

Veronica has over twenty years of healthcare administration experience. Her areas of expertise include revenue cycle, information systems, population health, and physician practice management. Most recently, she was the Director of Revenue Cycle Integrity at Cobleskill Regional Hospital. Prior to that, Veronica was the Chief Operating Officer for a large multispecialty, hospital-based physician practice based in New York. Veronica has an MBA in Healthcare Administration from Union College and a bachelor’s degree from the University at Albany. She is a member of HFMA and MGMA and has been Certified in Healthcare Compliance (CHC) by the Healthcare Compliance Association.