CMS released the 2025 OPPS and ASC Proposed Rule this morning. The 984 page document contains a number of important proposals including:
- 2.6% payment increase for eligible hospitals
- New conditions of participation (CoPs) for obstetrical services
- Updates to the Intensive Outpatient (IOP) and Partial Hospitalization (PHP) programs
- Separate payment for certain drugs and devices qualified as non-opioid treatments
- Separate payment for certain high cost diagnostic radiopharmaceuticals
- Addition of 3 new services to the inpatient only procedure (IPO) list related to liver allografts
- Adoption and removal of quality measures
- Additions to the approved ASC procedure list
We recommend reviewing the proposed rule in its entirety to identify all of the changes that may be applicable to your facility.
The Proposed Rule can be found here:
https://www.federalregister.gov/public-inspection/2024-15087/medicare-and-medicaid-programs-hospital-outpatient-prospective-payment-and-ambulatory-surgical
The CMS fact sheet can be accessed here:
CY 2025 Medicare Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System Proposed Rule (CMS 1809-P) | CMS |
