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April 2021 Update of the Hospital Outpatient Prospective Payment System (OPPS)

This Recurring Update Notification describes changes to and billing instructions for various payment policies implemented in the April 2021 OPPS update. The April 2021 Integrated Outpatient Code Editor (I/OCE) will reflect the Healthcare Common Procedure Coding System (HCPCS), Ambulatory Payment Classification (APC), HCPCS Modifier, and Revenue Code additions, changes, and deletions identified in this Change Request (CR). This Recurring Update Notification applies to Chapter 4, section 50.7.

The April 2021 revisions to I/OCE data files, instructions, and specifications are provided in the forthcoming April 2021 I/OCE CR.

Download the Guidance Document


Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: March 08, 2021

DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.