Hospital Outpatient Alert: Medicare Payment Changes — Action Required by January 1, 2024
Significant updates to Medicare OPPS and ASC payment systems effective January 1, 2024.
Action required by
January 1, 2024
Review the Action Required section below and ensure your team has completed all compliance steps before this date.
The recent Federal Register Final Rule outlines significant updates to the Medicare Hospital Outpatient Prospective Payment System (OPPS) and the Ambulatory Surgical Center (ASC) payment systems, effective January 1, 2024.
What Changed These changes will directly impact reimbursement rates for outpatient services, with adjustments anticipated in payment amounts across various service categories. While specific CPT, HCPCS, or ICD-10 codes affected by these changes are not detailed, it is crucial for clinical coders to refer to the source document for precise coding information. Coverage criteria, indications, and limitations for services under the OPPS and ASC systems may also be revised.
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Quick answers
What are the key changes in the OPPS and ASC payment systems?
The changes include adjustments to reimbursement rates for outpatient services effective January 1, 2024.
How can I find the specific codes affected by these changes?
Refer to the Federal Register Final Rule (Policy ID: FR-2023-24293) for detailed coding information.
What should I do to prepare for these changes?
Review the new payment structures, confirm changes to LCDs and NCDs, and audit reimbursement rates.
Content summarized from publicly available federal publications including CMS, MAC contractors, and the Federal Register. CLV Intelligence is not affiliated with or endorsed by any government agency. This is not legal or medical advice.