This increase factor is based on the final inpatient hospital market basket percentage increase of 3.3 percent for inpatient services paid under the hospital inpatient prospective payment system (“IPPS”) reduced by a final productivity adjustment of 0.2 percentage point. Updates to OPPS and ASC payment rates: CMS finalized OPPS payment rates for hospitals and ASCs that meet applicable quality reporting requirements by 3.1 percent. The CY 2024 OPPS/ASC Final Rule includes the following provisions. Below we provide an overview of key provisions included in the CY 2024 OPPS/ASC Final Rule. The provisions of the CY 2024 OPPS/ASC Final Rule are effective January 1, 2024.CMS also finalized its implementation of the intensive outpatient program benefit, expanding federal support for behavioral health services. CMS finalized changes to several hospital price transparency requirements, including requiring hospitals to use a template to submit charge information and requiring hospitals to affirm the accuracy of that information.In the CY 2024 OPPS/ASC Final Rule, CMS increased payment rates under the Hospital Outpatient Prospective Payment System and the ASC Payment System by a productivity-adjusted market basket factor of 3.1 percent.The final rule with comment period finalizes payment rates and policy changes affecting Medicare services furnished in hospital outpatient and ambulatory surgical center (“ASC”) settings for CY 2024. Erica Remer.ĬR13136: MM13136 – Hospital Outpatient Prospective Payment System: April 2023 Update (cms.On November 2, 2023, the Centers for Medicare & Medicaid Services (“CMS”) released the calendar year (“CY”) 2024 Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems Final Rule (“ CY 2024 OPPS/ASC Final Rule”). Programming note: Listen to Laurie Johnson’s live Coding Report every Tuesday on Talk Ten Tuesdays, 10 Eastern, with Chuck Buck and Dr. This document should be at the top of your reading list this week. The payment for APC 9138 will initially be $0.00 to prompt for the manual adjudication.Ĭhange Request 13136 contains a huge amount of information – especially for chargemaster coordinators and claim auditors. Payment will be based on average sales price (ASP). One (1) item, J1411 (injection, etranacogene dezaparvovec-drib, per therapeutic dose) will require manual adjudication.Two (2) drugs, biologicals, and radiopharmaceuticals had a status indicator change effective April 1 st.There are twelve (12) new drugs, biologicals, and radiopharmaceuticals effective April 1, 2023.New Drugs, Biologicals, and Radiopharmaceuticals.This code was removed effective March 31, 2023. C1834 (pressure sensor system, includes all components (e.g., introducer, sensor), intramuscular (implantable), excludes mobile (wireless) software application) was approved in error in the October 2022 release. One (1) code was removed from device pass-through status.The code is C1823 (generator, neurostimulator (implantable) non-rechargeable, with transvenous sensing and stimulation leads). A single code had its pass-through status expired effective Jan.C1827 – generator, neurostimulator (implantable), non-rechargeable lead and external paired stimulator controller.C1826 – generator, neurostimulator (implantable) includes closed feedback loop leads with rechargeable battery.C1747 – endoscope, single use, urinary tract has an offset of $507.69.
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