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.
For a fact sheet on the CY 2023 OPPS/ASC Payment System Final Rule (CMS-1772-FC), please visit here.
The November 16, 2023, issue of MLN Matters provides the updated information to the Centers for Medicare and Medicaid Services (CMS) guidance “Allowing Audiologists to Provide Certain Diagnostic Tests Without a Physician Order.” The revised guidance now adds two new audiology codes to use with the AB modifier for direct access without a physician or non-physician…
Late November 2, 2023, the Centers for Medicare and Medicaid Services (CMS) released the final 2024 Medicare Physician Fee Schedule (MPFS) and 2024 Hospital Outpatient Prospective Payment System rules. The rules take effect January 1, 2024. MPFS High-Level Take-Aways Quality Payment Program (QPP) Provisions CMS has added two new measures (317 and 498) to the…
The proposed rule for the Medicare Physician Fee Schedule (MPFS) for calendar year 2024 (CY24) shows another year of Medicare cuts for most providers, as reflected in the extensive red of the audiology code table included with a recent update from the Academy. The projected impact is a -2 percent cut overall for audiology codes…