2022 Hospital Outpatient Prospective Payment System (OPPS)/Ambulatory Surgery Center (ASC) Proposed Rule

On July 19, 2021, the Centers for Medicare and Medicaid Services (CMS) released the calendar year (CY) 2022 Hospital Outpatient Prospective Payment System (OPPS)/Ambulatory Surgery Center (ASC) Proposed Rule. The rule will be posted in the Federal Register on August 4, 2021 with comments due to CMS no later than September 19, 2021.   

What you need to know:

  • The conversion factors increase 2.3% to $84.46 for hospital outpatient departments
  • Echocardiography services are projected to increase ~3%. See chart here.
  • CMS is proposing to re-instate the Inpatient Only (IPO) List for 298 services.
  • For CY2022, CMS is proposing to halt the elimination of the IPO list and, to add the 298 services removed from the IPO list in CY 2021 back to the IPO list beginning in CY 2022. This change in policy would ensure that any service removed from the IPO list has been reviewed against Medicare’s longstanding IPO list criteria to determine if it is appropriate for Medicare to pay for the provision of the service in the outpatient setting. Furthermore, CMS is proposing to codify the longstanding criteria for removal of procedures from the IPO list to make clear in regulatory text how they will evaluate future procedures for removal.

More information:

ASE’s Advocacy Committee will be providing comments to CMS on behalf of ASE. Once the rules are finalized, we will provide a webinar for members to review the changes and impacts.