CHA DataSuite Releases Analysis of CY 2023 Medicare Outpatient Prospective Payment System Final Rule  

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CHA DataSuite has issued a hospital-specific analysis of calendar year (CY) 2023 Medicare outpatient prospective payment system (OPPS) final rule. The analysis is intended to show providers how Medicare outpatient fee-for-service payments will change from CY 2022 to CY 2023 based on the policies set forth in the final rule.  

The final rule includes policies that will: 

  • Use CY 2019 cost report data to set the payment rates due to the effects of the COVID–19 public health emergency 
  • Remove 11 services from the inpatient-only list and add eight services 
  • Add a new service category for prior authorization 
  • Eliminate the 340B payment reduction 
  • Exempt rural sole community hospitals from the reduced payment rate for clinic visit services furnished in excepted off-campus provider-based departments 
  • Establish a permanent 5% cap on wage index decreases 
  • Change the calculation of organ acquisition costs 
  • Outline provider enrollment requirements, quality program requirements, and payment methodologies for rural emergency hospitals 
  • Update the requirements for the hospital outpatient quality reporting program 
  • Update payment rates and policies for ambulatory surgical centers 

CHA members are invited to register for DataGen’s webinar on the CY 2023 OPPS final rule and analysis on Nov. 30 at noon (PT). Registration is required. 

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