Alert detail

Federal Register Final Rule: Medicare and Medicaid Programs: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems; Quality Reporting Programs, Including the Hospital Inpatient Quality Reporting Program; Health and Safety Standards for Obstetrical Services in Hospitals and Critical Access Hospitals; Prior Authorization; Requests for Information; Medicaid and CHIP Continuous Eligibility; Medicaid Clinic Services Four Walls Exceptions; Individuals Currently or Form

Policy ID: FR-2024-25521Specialty: Hospital Outpatient (OPPS)Added: 6/5/2026Effective: January 1, 2025final rule
Critical

What changed

Medicare OPPS and ASC payment system changes effective Jan 2025.

Who’s affected: Hospital Outpatient (OPPS) billing teams · Effective: January 1, 2025

Primary source: View the official CMS/MAC document ↗

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Federal Register Final Rule: Medicare and Medicaid Programs: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems; Quality Reporting Programs, Including the Hospital Inpatient Quality Reporting Program; Health and Safety Standards for Obstetrical Services in Hospitals and Critical Access Hospitals; Prior Authorization; Requests for Information; Medicaid and CHIP Continuous Eligibility; Medicaid Clinic Services Four Walls Exceptions; Individuals Currently or Form — FR-2024-25521