As a follow up to the October 18, 2021 blog post, “The FY 2022 Reimbursement Outlook,” CMS has since finalized the 3 rulings for the following payments systems: (1) Hospital Outpatient Payments (2) Ambulatory Surgery Center Payments, and (3) Physician Fee Schedule Payments. All three rulings will go into effect on January 1, 2022. Below includes the top 10 highlights:
Hospital Outpatient Payment (HOPD) Ruling
- In the final rule, overall outpatient payments will increase 2%.
- Cardiac and vascular procedures will see an average increase of 2.1%
- CMS finalized its proposal to halt the elimination of the Inpatient Only (IPO) list and add back the 298 services removed from the IPO list last year
- To increase price transparency, the Civil Monetary Penalty (CMP) for hospital non-compliance will increase from $300 per day to potentially $109,500 to $2,007,500 annually based on hospital bed count
Ambulatory Surgery Center (ASC) Ruling
- In the final rule, overall ASC payments will increase 2%
- Reinstatement of the ASC Covered Procedures List (ASC CPL) criteria and removal of 255 of the 267 procedures from the ASC CPL that were added in CY 2021
- However, the most common cardiovascular procedures remain on the CPL such as diagnostic cath, low-risk PCI, and most peripheral vascular and device implant procedures which will see an average payment increase of 2.5%
Physician Fee Schedule (PFS) Ruling
- In the final rule, the conversion factor will decrease by $1.30, from $34.89 to $33.59 — a 3.7% decline in reimbursement
- For the overall cardiology specialty, physicians can expect a decrease of approximately 1%
- The payment penalty phase of the Appropriate Use Criteria (AUC) program is delayed to either January 1, 2023, or the January 1 that follows the declared end of the PHE for COVID-19
Contact Corazon today to see how your facility will be affected by these upcoming changes in 2022!