The Centers for Medicare and Medicaid Services (CMS) released the calendar year 2023 Medicare Hospital Outpatient Prospective Payment System (HOPPS) and Ambulatory Surgical Center (ASC) final rule Nov. 1. The American College of Radiology® (ACR®) has created an initial review of provisions within the HOPPS final rule that may impact radiology or radiation oncology.
CMS increased the conversion factor by 3.8%, bringing it to $85.585 for CY 2023. There are no structural changes to the seven imaging ambulatory payment classifications (APCs), but the payment rates are modified. CMS modified the proposal to establish Healthcare Common Procedure Coding System (HCPCS) C-codes for Software as a Service (SaaS) procedures, and instead will recognize SaaS CPT add-on codes and will pay separately for them.
The ACR is reviewing the final rule and will release a detailed summary in the coming weeks. If you have any questions, email Kimberly Greck, ACR Economic Policy Analyst, or Christina Berry, ACR Team Lead, Economic Policy.
Read 2023 HOPPS ASC final rule-related documents: