CMS Releases Final 2023 Hospital Outpatient Prospective Payment System Rule

Hospital Outpatient Prospective Payment System

Late November 1, the Centers for Medicare and Medicaid Services (CMS) issued the final rule on the 2023 Hospital Outpatient Prospective Payment System (OPPS).

Under this rule, CMS finalizes a 3.8 percent increase in the OPPS payment rate for 2023, for those hospitals that meet quality reporting requirements.

The OPPS provides technical component (TC) reimbursement (non-physician costs such as supplies, equipment and personnel) for services provided in the outpatient setting. Under the OPPS, services are assigned to an Ambulatory Payment Classification (APC) group, and all services in the group are reimbursed at the same rate. Services included in an APC are supposed to be clinically similar and similar in resource use.

The Academy will continue to analyze the final rule for policy changes that may have an impact on audiology. A 2023 OPPS payment chart for audiology services is available here.

Resources

For a fact sheet on the CY 2023 OPPS/ASC Payment System Final Rule (CMS-1772-FC), please visit here.

The CY 2023 OPPS/ASC Payment System Final Rule can be viewed here.