November 7, 2022
CMS issues physician, outpatient/ASC, home health, and ESRD final 2023 payment rules
Last week, the Centers for Medicare and Medicaid Services (CMS) finalized four provider payment rules: Calendar Year (CY) 2023 Physician Fee Schedule (PFS); CY 2023 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System; CY 2023 Home Health Prospective Payment System (PPS); and CY 2023 End-Stage Renal Disease (ESRD) Prospective Payment System.
Through the rules, CMS is boosting payments for hospital outpatient services by 3.8%, home health services by 0.7%, and ESRD services by 3.1% while reducing payments under the physician fee schedule by 4.47%.
Provider groups are calling on Congress to step in and mitigate the payment cuts under the Medicare physician fee schedule, as they have in recent years, noting that the cuts are particularly harmful amid financial headwinds due to inflation, increased supply costs, and an unprecedented shortage in the health care workforce. While there is some momentum in Congress to address the fee schedule cuts, as well as other statutory cuts impacting the Medicare provider population in a year-end spending package, the prospects of any relief will become clearer after the mid-term elections. Hospital groups and home health groups, separately, have raised concerns about their CY 2023 payment rates, with hospital groups warning that the finalized outpatient payment rate increase does not keep pace with inflation and home health providers warning that the final rule still retains large permanent payment adjustments that will be detrimental to the industry, despite delaying some to future years.
Additional information is also available in the attached Tax Alert.
CY2023 final payment rules