News: CMS releases proposed CY 2025 OPPS revision
CMS released a proposed rule revising the calendar year (CY) 2025 Outpatient Prospective Payment System (OPPS) that would increase the payment rate for outpatient hospital services by 2.6%.
CMS says the increase was based on a proposed 3% inpatient hospital market basket increase for inpatient services paid under the Hospital Inpatient Prospective Payment System (IPPS), and then reduced by a proposed productivity adjustment of 0.4 percentage points, according to JustCoding.
With this update, CMS estimates an increase of approximately $5.2 billion in total payments to OPPS organizations totaling $88.2 billion in CY 2025, compared to estimated CY 2024 payments. The proposed rule also contains amendments and modifications to the following programs and services:
- Intensive outpatient program
- Partial hospitalization program (with rates)
- Access to non-opioid treatments for pain relief
- Remote services
- Rates for high-cost drugs in a tribal setting
- Radiopharmaceuticals
- Hospital quality reporting
- Rural emergency hospital quality reporting
- Obstetric/gynecological services
Editor’s note: To read the JustCoding coverage, click here. To read the CMS fact sheet, click here. To read the full proposed revision to the rule, click here.