What is “OPPS” in medical billing?

OPPS in Medical Billing

OPPS stands for Outpatient Prospective Payment System, a Medicare payment system for outpatient services provided by hospitals.

OPPS in Medical Billing Explained

In medical billing, OPPS establishes fixed payment rates for outpatient services provided by hospitals. This system streamlines billing and ensures consistent reimbursement rates for outpatient care, including surgeries, lab tests, and imaging.

For example, a hospital bills Medicare for an outpatient surgery, and payment is determined according to OPPS rates.

Check acronyms and abbreviations in Medical billing glossary.

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