Hospital Outpatient Prospective Payment System

The Hospital Outpatient Prospective Payment System (HOPPS) is used by CMS to reimburse for hospital outpatient services. The CMS created HOPPS to reduce beneficiary copayments in response to rapidly growing Medicare expenditures for outpatient services and large copayments being made by Medicare beneficiaries.

All covered outpatient services belong to an Ambulatory Payment Classification (APC) group. Each group of procedure (i.e., codes) within an APC is supposed to be “similar clinically and with regard to resource consumption.”


Below we provide several background documents on HOPPS

Hospital Outpatient Prospective Payment System Rule

Below we provide detailed summaries for recent proposed HOPPS rules.

Radiology Coding Source


Feel secure about your coding proficiency and keep up-to-date on Medicare policies with our bimonthly newsletter for radiology coding and reimbursement news.

Access the Coding Source

Imaging 3.0


The technology tools of Imaging 3.0 are designed to equip 21st-century radiologists to ensure their key role in evolving health care delivery and payment models — and quality patient care.

Get Involved