CMS issues proposed rule for hospital outpatient, ASC payment rates for CY 2023

Editor's Note

The Centers for Medicare & Medicaid Services (CMS) on July 15 released its Outpatient Prospective Payment System (OPPS) proposed rule that would raise rates by a net 2.7% in CY 2023. This update is based on the projected hospital market basket percentage increase of 3.1%, reduced by 0.4% for the productivity adjustment.

In CY 2019, CMS finalized the proposal to apply the productivity-adjusted hospital market basket update to ASC payment system rates for 5 years (CY 2019 through CY 2023). Using the hospital market basket update, CMS is proposing to update ASC rates by 2.7%, if the ASCs meet quality reporting requirements.

CMS proposes removing 10 services from the inpatient only (IPO) list and adding one procedure to the ASC covered procedures list. The procedures were removed in CY 2021 as part of eliminating the IPO list, but they were added back when the elimination process stopped last year.

CMS will accept comments on the proposed rule through September 13.