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Research Letter
October 24, 2019

Financial Implications of Site-Neutral Payments for Clinic Visits in Otolaryngology

Author Affiliations
  • 1The Warren Alpert Medical School, Brown University, Providence, Rhode Island
  • 2Massachusetts Eye and Ear, Boston
  • 3Harvard Business School, Boston, Massachusetts
  • 4Department of Otolaryngology, Harvard Medical School, Boston, Massachusetts
JAMA Otolaryngol Head Neck Surg. 2020;146(1):78-79. doi:10.1001/jamaoto.2019.3229

In January 2020, the Centers for Medicare & Medicaid Services (CMS) will implement site-neutral payments for outpatient clinic visits occurring in the off-campus hospital outpatient department (HOPD-OFF) setting.1 Following the establishment of the Hospital Outpatient Prospective Payment System (OPPS) in April 2000, hospitals have received separate Medicare payments for HOPD-OFF clinic visits under the OPPS and the Physician Fee Schedule. Under this reform, hospitals will receive a single payment under the OPPS equivalent to the Physician Fee Schedule rate, thereby reducing Medicare reimbursement by 60% per visit. The CMS estimates that this payment reduction will save Medicare $610 million in 2020.1