CMS Proposal on Hospital Outpatient Payment Panel Open for Comment

The Centers for Medicare & Medicaid Services held its first Hospital Outpatient Payment Panel meetings this year and has issued proposals on the changes to current supervision levels for the following categories:

• Influenza, pneumococcal, and hepatitis B vaccine administration
• Trimming of nails
• Venipuncture via vein, VAD, or central catheter
• Foley catheter insertion
• Changing of cystostomy tube
• Bladder scan for residual urine measurement
• Refilling portable pump
• Irrigation of implanted VAD
• IV hydration, initial hour and each additional hour

The last item, IV hydration, had been previously identified by CMS as a "non-surgical extended duration service," in the CY 2011 OPPS final rule. These types of services must be provided under direct supervision during the initiation of the service, followed by general supervision for the remainder of the service, says Debbie Mackaman, RHIA, CHCO, regulatory specialist for HCPro, Inc.