In the ASC payment system, how do the conversion factors and weights compare to OPPS?

In the ASC payment system, how do the conversion factors and weights compare to OPPS?

• A. Less than OPPS
• B. Greater than OPPS
• C. Equal to OPPS
• D. Not defined

Answer: (A)

In this area, both systems use a conversion factor multiplied by a relative weight (case weight) to determine the payment for a procedure. Ambulatory Surgical Centers have their own conversion factor and set of weights that are generally lower than those used in the hospital Outpatient Prospective Payment System. This reflects the typical lower overhead and different resource use in an ASC compared with a hospital outpatient department. As a result, the per-procedure payments in the ASC system tend to be smaller than those under OPPS. The other options don’t fit because ASC values are not set higher, nor equal, nor undefined relative to OPPS.

In this area, both systems use a conversion factor multiplied by a relative weight (case weight) to determine the payment for a procedure. Ambulatory Surgical Centers have their own conversion factor and set of weights that are generally lower than those used in the hospital Outpatient Prospective Payment System. This reflects the typical lower overhead and different resource use in an ASC compared with a hospital outpatient department. As a result, the per-procedure payments in the ASC system tend to be smaller than those under OPPS. The other options don’t fit because ASC values are not set higher, nor equal, nor undefined relative to OPPS.