CMS floats 2.8% outpatient pay bump for 2024: 7 takeaways

CMS has released its Outpatient Prospective Payment System proposed rule for 2024, which would raise Medicare outpatient payment rates for hospitals and ASCs next year. 

Seven takeaways: 

1. CMS has proposed a 2.8 percent pay increase for outpatient facilities in 2024. The proposed increase includes a 3 percent market payment update, offset by a 0.2 percent cut for productivity. The proposal would pay acute care hospitals $88.6 billion for outpatient services in 2024 — 2.8 percent more than this year. 

2. Under the proposed rule, Medicare payments for hospital outpatient departments would increase by $6 billion in 2024 while Medicare ASC payments would total $6 billion, according to Bloomberg Law

3. CMS also pitched the creation of the intensive outpatient program payment, a new benefit category, to improve access to behavioral healthcare. The proposed rule includes the scope of benefits, physician certification requirements, coding and billing, and payment rates under the IOP benefit. CMS believes this would address one of the main gaps in behavioral health coverage in Medicare and promote access to behavioral healthcare.

4. CMS also proposed pay updates for tribal and Indian Health Service hospitals converting to Rural Emergency Hospitals in addition to updating pay rates for partial hospitalization program services in hospital outpatient departments and community mental health centers. 

5. The agency also aims to push its hospital price transparency initiative forward. Proposed changes for 2024 would modify standard charge display requirements and enforcement provisions to streamline and improve the transparency of the enforcement process. Hospitals would be required to use a specific template when displaying the required standard charges in a machine-readable file and also encode all standard charge information.

6. CMS is also proposing that hospitals be required to place a footer on their homepage that links to the webpage that includes the machine-readable file and ensure that a .txt file is included in the root folder of the website that features its machine-readable file. CMS believes these two proposed changes will improve automated accessibility to hospital standard charges information and help the agency to enforce the requirements.

7. CMS is seeking comments on the proposed rule through Sept. 11 and will issue the final rule in early November. 

Click here to read the 963-page proposed rule.

Copyright © 2024 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.


Featured Whitepapers

Featured Webinars