CMS Releases the Medicare 2023 OPPS Proposed Rule

News & Press: Advocacy

Tuesday, July 26, 2022 (0 Comments)
Posted by: Audrey Gentry

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On July 15, the Centers for Medicare & Medicaid Services (CMS) released the 2023 Medicare Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) proposed rule (CMS-1772 P). The rule provides for a 60-day comment period ending on September 13, 2022.

In addition to proposing updated payment rates, this year’s rule includes proposals that align with several key goals of the administration, including advancing health equity in rural areas, promoting competition in the health care system, and promoting safe, effective and patient-centered care. The rule proposes payment for APC 5521 (CPT® code 75571) at $88.16, a 6.2% increase over the 2022 payment rate with the proposed payment for APC 5571 (CPT® Codes 75572, 75573 and 75574) at $183.61, an increase of 31 cents over the 2022 payment rate.

SCCT remains concerned about the inadequate Medicare payment rate which does not capture the clinical intensity, resource utilization, and cost for providing CCT services. SCCT will once again call on members to submit comments to CMS to correct the profoundly low Medicare reimbursement for cardiac computed tomography angiography (CCTA).