CMS Releases 2022 Hospital Outpatient Prospective Payment System Final Rule

News | Published: Tuesday, November 2, 2021

The Centers for Medicare and Medicaid Services (CMS) on Nov. 2 released the 2022 Hospital Outpatient Prospective Payment System (OPPS) final rule. The final rule indicates a 2% payment update for hospitals and sets other policies.

Highlights from the OPPS rule include:

  • Use of calendar year (CY) 2019 claims data for CY 2022 OPPS and Ambulatory Surgery Center (ASC) Payment System rate setting due to the COVID-19 Public Health Emergency.
  • A decision to halt the elimination of the Inpatient Only (IPO) List for CY 2022, based on overwhelming stakeholder feedback during the 2021 rulemaking cycle. CMS added back the 298 services removed from the IPO list last year. Additionally, CMS codified the long-standing criteria for removal of procedures from the IPO list.
  • Reinstatement of the ASC Covered Procedures List (ASC CPL) criteria and removal of 255 of the 267 procedures from the ASC CPL that were added in CY 2021. A new nomination process for adding services to the CPL was also adopted that would allow an external party to nominate a surgical procedure to be added to the ASC CPL in the next applicable rulemaking cycle.

CMS also released the 2022 Medicare Physician Fee Schedule (PFS) final rule. View highlights here.

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