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A Look Back: Payment Rate Updates Take Center Stage

Analysis  |  By Amanda Norris  
   November 23, 2022

The 2023 OPPS and Medicare physician fee schedule final rules were top of mind in the revenue cycle this month.

Look at the top trending revenue cycle stories from HealthLeaders this month, both of which cover recent payment rate updates to hospitals and physicians.

CMS released the 2023 OPPS final rule that includes increased Medicare reimbursement and the establishment of a new provider type, but hospital groups say it's not enough.

CMS recently released the 2023 OPPS final rule, which brought increased hospital outpatient payment rates, the establishment of a new provider type, and 340B payment finalization.

According to the final rule, CMS has increased Medicare reimbursement for hospital outpatient departments by 3.8%, reflecting a hospital market basket increase of 4.1 percent and a 0.3 percentage point decrease for productivity. This is higher than the 2.7% update included in the proposed rule earlier this year.

Blow-back from the proposed payment rate increase of 2.7% may have played a role in the finalized amount of 3.8%.

Read more from this story here.

Ninety percent of medical practices reported that the payment cuts found in the 2023 Medicare physician fee schedule would reduce access to care, the MGMA says.

Physician payment cuts are coming, significant changes to E/M services are finalized, and key reporting revisions are hitting telehealth and audio-only services, according to the final 2023 Medicare physician fee schedule.

Proposed payment cuts that drew vocal criticism from physician advocacy groups will move forward as planned, as CMS announced a 4.5% reduction to the 2023 Medicare Part B conversion factor (CF), effective January 1.

The CF will fall to $33.0607 in 2023, down from $34.6062 in 2022, largely due to budget neutrality adjustments. The final CF for 2023 is two cents lower than the rate CMS first proposed in July, according to Part B News.

The anesthesia conversion factor will also take a hit next year, down 4.4% as proposed.

Read more from this story here.

Amanda Norris is the Revenue Cycle Editor for HealthLeaders.


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