CY 2022 OPPS/ASC Final Rule Summary

CMS released the calendar year 2022 final rule for Medicare’s hospital outpatient prospective payment system (OPPS) and ambulatory surgical center (ASC) payment system (CMS-1753-FC) on November 2, 2021. Policies in the final rule will generally go into effect on January 1, 2022, unless otherwise specified. The final rule will be published in the November 16, 2021 issue of the Federal Register. There is a 30-day public comment period on the interim APC assignments and/or status indicators of new or replacement Level II HCPCS codes that were not previously subject to comment for both the OPPS and ASC payment systems. The public comment period will end on December 2, 2021. 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. CMS is also making changes to its hospital price transparency initiative including increasing penalties for non-compliance. Changes to the Radiation Oncology Model are included as well. The 2022 OPPS/ASC proposed rule included requests for information on digital quality information, interoperability and Rural Emergency Hospitals. CMS summarizes the public comments received on digital quality information and interoperability and indicated it would take these comments into consideration in the future rulemaking. No information appears in the final rule on Rural Emergency Hospitals.