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1 lis 2024 · The Centers for Medicare & Medicaid Services Nov. 1 issued a final rule that increases Medicare hospital outpatient prospective payment system rates by a net 2.9% in calendar year 2025 compared to 2024. This includes a 3.4% market basket update, offset by a 0.5 percentage point cut for productivity.
One of the biggest changes for 2024 is the Ambulatory Payment Classification (APC) reassignment of total shoulder arthroplasty (CPT® code 23472) from APC 5115 to APC 5116, resulting in a 36.2% payment increase ($17,775; +$4,727) compared to CY 2023.
2 lis 2023 · For CY 2024, CMS is finalizing Medicare payment rates under the OPPS for over 240 dental codes to align with the dental payment provisions in the CY 2023 Physician Fee Schedule final rule by assigning them to clinical APCs.
4 lis 2024 · The Biden administration has finalized 2025 Medicare reimbursement rates for physicians and hospital clinics that providers agree aren’t large enough in light of rising costs.
Updates of Addendum A and B are posted quarterly to the OPPS website. These addenda are a "snapshot" of HCPCS codes and their status indicators, APC groups, and OPPS payment rates, that are in effect at the beginning of each quarter.
1 lis 2022 · The CY 2023 OPPS/ASC final rule updates Medicare payment rates for partial hospitalization program (PHP) services furnished in hospital outpatient departments and community mental health centers (CMHCs).
11 sty 2024 · The Medicare Payment Advisory Commission Jan. 11 voted to recommend that Congress update Medicare payment rates for hospital inpatient and outpatient services by the current law amount plus 1.5% for 2025, and reiterated its recommendation to distribute an additional $4 billion to safety-net hospitals by transitioning to a Medicare safety-net ...
