2022 IPPS Final Rule

Last week, CMS issued the 2022 Medicare Hospital Inpatient Prospective Payment System (IPPS) Final Rule. The changes contained within the 2,295 pages of the Final Rule will take effect October 1, 2021.  The Final Rule adopts many of the changes included in the Proposed Rule along with some minor modifications including:

  • Overall increase in IPPS payments of 2.7%
  • Repeal of the price transparency requirement for hospitals to report their median payer-specific negotiated rates for inpatient services by MS-DRG for Medicare Advantage organizations
  • A +0.5 percent adjustment to the standardized amount of Medicare payments to acute care hospitals for MS-DRG documentation and coding changes
  • Extension of the New COVID-19 Treatments Add-on Payment (NCTAP) through the end of the fiscal year following the end of the PHE
  • Reporting of COVID-19 vaccination coverage among health care personnel for the period October 1, 2021-December 31, 2021
  • Changes to the CC list: 11 New, 1 Deleted
  • Changes to the MCC list: 9 New, 2 Deleted
  • Delayed changes to MS-DRGs severity level splits until FY 2023 or later
  • Changes to MS-DRG assignments
  • ICD-10 updates including new, invalid and revised diagnosis and procedure codes
  • Changes to policies for the Hospital Readmissions Reduction Program
  • Changes to the Hospital Inpatient Quality Reporting (IQR) Program

We recommend you read the complete Final Rule to understand the changes and potential impact to your facility. 

The final rule can be accessed here:  https://public-inspection.federalregister.gov/2021-16519.pdf

CMS Fact Sheet:  https://www.cms.gov/newsroom/fact-sheets/fiscal-year-fy-2022-medicare-hospital-inpatient-prospective-payment-system-ipps-and-long-term-care-0

HBE’s team of coding and compliance experts is available to assist you external reviews of your documentation, coding and reimbursement as well as providing customized education and training for your staff.  We are also available to provide assistance with conducting risk assessments, internal investigations and policy and procedure development.  

DISCLAIMER:  This newsletter contains only summary information and highlights; it should be read in conjunction with the full article or document provided as a link.  Any advice or recommendations are general and specific questions should be directed to professional counsel

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