CY 2023 OPPS/ASC Final Rule Summary

CMS released the calendar year 2023 final rule for Medicare’s hospital outpatient prospective payment system (OPPS) and ambulatory surgical center (ASC) payment system (CMS-1772-FC) on November 1, 2022. Policies in the final rule will generally go into effect on January 1, 2023 unless otherwise specified. The final rule will be published in the November 23, 2022, issue of the Federal Register. The public comment period will end on January 3, 2023. Public comments will be accepted on the codes listed in Addendum B of the final rule with a Comment Indicator of “NI” or “NP”—codes with either an interim or proposed Ambulatory Payment Classification where CMS has not previously sought comment. The final rule updates OPPS payment policies that apply to outpatient services provided to Medicare beneficiaries by general acute care hospitals, inpatient rehabilitation facilities, inpatient psychiatric facilities, long-term acute care hospitals, children’s hospitals, and cancer hospitals, as well as for partial hospitalization services in community mental health centers. Also included is the annual update to the ASC payment system and updates and refinements to the requirements for the Hospital Outpatient Quality Reporting Program and the ASC Quality Reporting Program.