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CMS Releases OPPS and ASC Proposed Rule

Members & Publications

July 29, 2022

On July 15, 2022, the Centers for Medicare & Medicaid Services released the Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System proposed rule.  The rule details proposed payment and policy for outpatient and ASC services beginning January 1, 2023.  Academy staff is reviewing the rule and will be preparing comments for submission to CMS by the September 13 deadline.  The rule proposes an overall payment rate update of 2.7% for hospitals that meet quality reporting requirements.  Of significant note to Academy members, the rule includes a proposal to require prior authorization for facet joint injections and nerve destruction.  Comments regarding this proposed policy will be prioritized in the Academy comment letter.  A fact sheet for the rule can be found on the CMS website.  Members with questions about the OPPS and ASC proposed rule can contact Academy staff at healthpolicy@aapmr.org.  

Legislation Introduced to Alleviate Impact of Conversion Factor Cut for 2021

Nov 09, 2020

Last month, two bills were introduced in the House proposing solutions to the estimated 10.6% Physician Fee Schedule conversion factor cut expected to go into effect January 1, 2021.  The bills offer some relief to the cut, but do not reflect a comprehensive or long-term solution.  AAPM&R has therefore chosen to remain neutral regarding these bills. 

Your Academy continues to advocate for a permanent solution to the conversion factor cut while maintaining the important payment increases to office and outpatient evaluation and management services.

 

 

 

 

 

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