This publication provides the following information about the Hospital Outpatient Prospective Payment System (OPPS):

• Background;
• Ambulatory payment classifications (APCs);
• How payment rates are set;
• Payment rates;
• Hospital Outpatient Quality Reporting (OQR) Program; and

Final Rule with Comment Period and
Final Payment Rates

There is no CMS PC Pricer application for Outpatient PPS at this time. The files contain the logic, rates, wage index, and off-set amounts used by the OPPS PRICER program to calculate APC rates, coinsurance and deductibles.