On November 2, 2021, the Centers for Medicare & Medicaid Services (CMS) released the calendar year (CY) 2022 Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems Final Rule [CMS-1753-F], finalizing payment rates and policy changes affecting Medicare services furnished in hospital outpatient and ambulatory surgical center (ASC) settings for CY 2022.
For CY 2022, CMS increased payment rates under the Hospital Outpatient Prospective Payment System (OPPS) and the ASC Payment System by a factor of 2%. Hospitals and ASCs that fail to meet their respective quality reporting program requirements will be subject to a 2% reduction.
Based on the finalized policies, CMS estimates that total payments to OPPS and ASC providers (including beneficiary cost-sharing and estimated changes in enrollment, utilization and case-mix) for CY 2022 will be approximately $82.078 billion and $5.41 billion, respectively, for an increase of approximately $5.9 billion and $40 million, respectively, from CY 2021 program payments.
The finalized regulations are available here. The press release and accompanying fact sheet are available here and here, respectively.
Key takeaways from the CY 2022 OPPS and ASC Payment System Final Rule:
For more information, contact Jennifer Archer, Aaron Badida, Deborah Godes, Sheila Madhani, Kristin O’Brien, Jennifer Ohn and Devin Stone.