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ACR Supports Per-Day Threshold in the 2025 HOPPS Rule
Sept. 11, 2024
The American College of Radiology® (ACR®) submitted comments to the Centers for Medicare and Medicaid Services (CMS) related to the calendar year (CY) 2025 Hospital Outpatient Prospective Payment System (HOPPS) proposed rule that address radiology-specific issues and make specific recommendations.
The letter outlines support for the rule’s proposed per-day threshold of $630 to separately pay for diagnostic radiopharmaceuticals but recommends that CMS move toward using Average Sales Price (ASP) to set future years’ calculations for more accurate reimbursement.
The College also lays out potential strategies for CMS to make updates to increase HOPPS payments for CT colonography screening services, which are proposed to be covered via the 2025 Medicare Physician Fee Schedule proposed rule.
CMS will take the comments from stakeholders into consideration and release the final HOPPS rule this November. If finalized, these policies will take effect Jan 1.
If you have questions about the ACR’s HOPPS proposed rule comments, contact Kimberly Greck, ACR Senior Economic Policy Analyst.
The letter outlines support for the rule’s proposed per-day threshold of $630 to separately pay for diagnostic radiopharmaceuticals but recommends that CMS move toward using Average Sales Price (ASP) to set future years’ calculations for more accurate reimbursement.
The College also lays out potential strategies for CMS to make updates to increase HOPPS payments for CT colonography screening services, which are proposed to be covered via the 2025 Medicare Physician Fee Schedule proposed rule.
CMS will take the comments from stakeholders into consideration and release the final HOPPS rule this November. If finalized, these policies will take effect Jan 1.
If you have questions about the ACR’s HOPPS proposed rule comments, contact Kimberly Greck, ACR Senior Economic Policy Analyst.