On July 10, CMS released the proposed rule for the calendar year (CY) 2025 Hospital Outpatient and Prospective Payment System (OPPS) and Ambulatory Surgery Center (ASC) Payment System. CMS proposes to update hospital outpatient payments by 2.6%. Comments are due on Sept. 9.
- A link to the proposed rule is available here.
- A CMS OPPS/ASC press release is available here.
- A CMS OPPS/ASC CMS fact sheet is available here.
Washington Office staff will be preparing a list of issues of interest to neurosurgeons and helping to draft letters for review by leadership. Initial issues of interest include:
- Separate Payment for Non-opioid Pain Treatment. CMS is proposing to implement a provision of the Consolidated Appropriations Act (CAA) of 2023, which provides temporary additional payments for certain non-opioid treatments for pain relief in the hospital outpatient department (HOPD) and ASC settings from Jan. 1, 2025, through Dec. 31, 2027. They have identified seven drugs and one device (the Elastomeric infusion pump, non-opioid pain management delivery system, including catheter and other system components) as qualifying non-opioid treatments to be paid separately in both the HOPD and ASC settings. The AANS and the CNS have supported separate payments for non-opioid products, especially for devices.
- Hospital Outpatient Quality Reporting (OQR) Program. CMS proposes to remove the following two measures from the program beginning with the CY 2025 reporting period/CY 2027 payment determination due to a determination that performance on the measures is not tied to better patient outcomes:
- MRI Lumbar Spine for Low Back Pain measure
- Cardiac Imaging for Preoperative Risk Assessment for Non-Cardiac, Low-Risk Surgery measure
