Laboratory Question for the Week of April 11, 2016

Laboratory Compliance Question of the Week

Question:

I am just learning about the use of OPPS packaging for laboratory services. Why did CMS move payment for most of these services from the clinical laboratory fee schedule to the hospital OPPS?

Answer:

The Centers for Medicare & Medicaid Services (CMS) believe that packaging laboratory

and other services and paying them by way of an outpatient prospective payment system (OPPS) ambulatory payment classification (APC) will help control rising costs. Hospitals that keep their costs of services under the APC amount could make money, and hospitals that don’t manage costs as well could lose money.

Disclaimer: Every reasonable effort was made to ensure the accuracy of this information at the time it was published. However, due to the nature of industry changes over time we cannot guarantee its validity after the year it was published.