CMS Releases the 2023 IPPS Final Rule

Yesterday, CMS released the 2023 Inpatient Prospective Payment Final Rule.  The 2,087 page document includes some major changes for the upcoming year including:

  • 4.3% increase in operating payments for acute care hospitals – 1.1% higher than what was stated in the proposed rule
    • Individual hospitals may receive reductions for excessive readmissions
  • Changes to the Value-Based Purchasing Program for FY 2023 including pausing measures and not calculating a hospital Total Performance Score (TPS) 
  • Pausing all six measures in the HAC Reduction Program meaning no hospital penalties for the 2023 program year
  • Addition of 1,179 ICD-10 diagnosis codes
  • Addition of 340 ICD-10 procedure codes
  • Reclassifying almost 300 ICD-10 diagnosis codes as invalid
  • Addition of more than 150 ICD-10 diagnosis codes to the CC and MCC lists
  • Removal of 17 ICD-10 diagnosis codes from the CC and MCC lists
  • No changes to the number of MS-DRGs (767)
  • Multiple new provisions for the Hospital Inpatient Quality-Reporting Program, including adoption of 10 new quality measures
  • New provisions related to the Interoperability Program, including new measures and public reporting of certain data
  • GME changes and modified policies that address the FTE cap as well as added flexibilities for urban and rural hospitals with Rural Training Programs (RTPs)

We recommend reviewing the changes in their entirety and begin preparing for necessary updates and start the education and training process for your clinical and administrative staff. 

As a reminder, the ICD-10 changes will be effective on October 1, 2022.  

The HBE experts are available to assist your organization with effective implementation of all of these important changes.

The Final Rule may be found here:

The addenda may be found here:

The fact sheet may be found here:

HBE’s team of experts is also available to assist you with routine auditing and monitoring, policy and procedure development as well as customized education and training for your clinical and administrative staff.

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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