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.
Updated Guidance November 9, 2022 Late November 1, 2022, the Centers for Medicare and Medicaid Services (CMS) issued the Final Rule on the 2023 Medicare Physician Fee Schedule (MPFS). The Academy has compiled a chart of 2023 reimbursement values for audiology codes, available here. This Final Rule contains significant provisions for the delivery of audiology services….
On November 1, 2022, the Centers for Medicare and Medicaid Services (CMS) issued a pre-release notice of final rule-making for the CY 2023 Medicare Physician Fee Schedule Rule (MPFS). The notice will be final upon publication in the Federal Register. CMS also has provided a Fact Sheet that references significant changes for the provision of…
CMS developed the National Correct Coding Initiative (NCCI) to promote national correct coding methodologies and to control improper coding leading to inappropriate payment in Part B claims. The tables below detail CCI edits related to audiology, and have been prepared based on the complete list of edits published on CMS’s CCI Web site. The edits contained…