Outpatient Prospective Payment Systems (OPPS)
CMS generally makes payment for hospital outpatient department services through the Hospital Outpatient Prospective Payment System (OPPS).
The Centers for Medicare & Medicaid Services (CMS) Nov. 2 released its calendar year (CY) 2024 outpatient prospective payment system (OPPS) and ambulatory surgical center (ASC) final rule. It increases OPPS rates by a net 3.1% in CY 2024 compared to CY 2023 and includes final policies regarding鈥
The AHA is concerned that CMS has again finalized an inadequate update to hospital payments. Today's increase for outpatient hospitals of only 3.1% comes in spite of persistent financial headwinds facing the field.
The Centers for Medicare & Medicaid Services Nov. 2 issued a final rule that increases Medicare hospital outpatient prospective payment system rates by a net 3.1% in calendar year 2024 compared to 2023. This includes a 3.3% market basket update, offset by a 0.2% cut for productivity.
In comments submitted today, AHA expressed strong concern about the proposed hospital outpatient market basket update, noting it 鈥渄oes not capture either the unprecedented inflationary environment or the other persistent financial headwinds hospitals and health systems are experiencing.鈥
Webinar: The CY 2024 Outpatient PPS/ASC Payment System Proposed Rule August 18, 2023.
The AHA is deeply concerned that CMS is proposing a CY 2024 outpatient hospital payment update of only 2.8% despite persistent financial headwinds facing the hospital field.
Lookup Tool: The third spreadsheet is an OPPS APC/HCPCS lookup tool that allows the user to pull-up basic descriptive and payment information for a code.
The Addendum B Spreadsheet compares relative weights and payment rates at the HCPCS level, using proposed rule Addendum B compared to 2023 Addendum B (July 1, 2023 file).
The Addendum A spreadsheet compares relative weights and payment rates at the APC level, using the 2024 proposed rule Addendum A compared to 2023 Addendum A (July 1, 2023 file), as downloaded from the CMS website.
The 黑料正能量 Association would like to provide feedback on sections of H.R. 4822, the 鈥淗ealth Care Price Transparency Act of 2023,鈥 as well as H.R. 3284, the 鈥淧roviders and Payers COMPETE Act.鈥