Last week the Centers for Medicare and Medicaid Services (CMS) released their final rules for calendar 2014 for the outpatient prospective payment system (OPPS) and the physician fee schedule (PFS). Among other modifications to the OPPS, CMS announced its final determination to end the current enforcement moratorium for small, rural hospitals and Critical Access Hospitals in regards to compliance with “direct supervision” requirements for outpatient therapy services. As part of the physician fee schedule update, CMS indicated the method and manner in which they plan to enforce SGR and GPCI cuts that will take affect in January if Congress does not intervene. They also outlined how therapy caps will be applied to Critical Access Hospitals and modified their definition of “rural” for purposes of telehealth reimbursement. The OPPS final rule is available here and the PFS final rule is available here.