Revisions to 2011 Medicare Reimbursement for Outpatient Hospitalization

by Rebecca Farley on November 5, 2010

The Centers for Medicare and Medicaid Services has submitted final regulations outlining Medicare reimbursement for outpatient hospital services for calendar year 2011. The new payment policies, which become effective on Jan. 1, 2011, include a reimbursement reduction for outpatient hospital services provided by community mental health centers (CMHCs).

In an earlier version of this regulation, CMS proposed a change to the formula by which CMHCs are reimbursed by Medicare for outpatient hospitalization services, which would have resulted in a 41.7% cut for such services in 2011. The National Council opposed this reduction (see our comments to CMS here). In its final rule, CMS agreed to implement a two-year phase-in of the new formula so as to mitigate the burden of the cuts on CMHCs.

The National Association for Behavioral Health has published a summary of the final 2011 reimbursement changes. Click here to view.

The final rule is available here through Nov. 24; on that date it will be published in the Federal Register.

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