Released on Jul 19, 2022

Medicare 2023 Proposed OPPS and ASC Payment Policies Released

On July 15, the Centers for Medicare and Medicaid Services (CMS) released the calendar year (CY) 2023 Medicare Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems Proposed Rule.

Topline Takeaways:

  • Slight Increase in Facility Fees Payments: The proposed CY 2023 Medicare conversion factor for outpatient hospital departments is $86.785, an increase of 2.7%, for hospitals that meet applicable quality reporting requirements. 
  • Slight Increase in ASC Payments: The proposed CY 2023 ASC conversion factor is $51.315, an increase of 2.7%, for ASCs that meet applicable quality reporting requirements. The GI societies continue to urge CMS to reduce this gap in the ASC facility fees when compared to the outpatient hospital facility rates, which are estimated to be a roughly 50% differential in CY 2023. 
  • 18% cuts to some motility and G-tube codes: Hospital outpatient facility payments for motility codes 91117 and 91122 and G-tube codes 43261-43263 could decrease by 18% due to proposed changes to their Ambulatory Payment Classification (APC) family. 

Outpatient Prospective Payment and Ambulatory Surgical Center Payment System Payment Charts

To find out more about the proposed rule, read the GI societies’ summary

CMS OPPS/ASC Proposed Rules and Fact Sheets

CY 2023 OPPS/ASC Payment System Proposed Rule

CY 2023 OPPS/ASC Payment System Proposed Rule Fact Sheet

Medicare Physician Fee Schedule (MPFS) Proposed Rule

On July 7, CMS released the calendar year (CY) 2023 Medicare Physician Fee Schedule (MPFS) proposed rule. Read the GI societies’ summary on the impact to our members and patients.

 


About Gastrointestinal Endoscopy
Gastrointestinal endoscopic procedures allow the gastroenterologist to visually inspect the upper gastrointestinal tract (esophagus, stomach and duodenum) and the lower bowel (colon and rectum) through an endoscope, a thin, flexible device with a lighted end and a powerful lens system. Endoscopy has been a major advance in the treatment of gastrointestinal diseases. For example, the use of endoscopes allows the detection of ulcers, cancers, polyps and sites of internal bleeding. Through endoscopy, tissue samples (biopsies) may be obtained, areas of blockage can be opened and active bleeding can be stopped. Polyps in the colon can be removed, which has been shown to prevent colon cancer.

About the American Society for Gastrointestinal Endoscopy
Since its founding in 1941, the American Society for Gastrointestinal Endoscopy (ASGE) has been dedicated to advancing patient care and digestive health by promoting excellence and innovation in gastrointestinal endoscopy. ASGE, with almost 15,000 members worldwide, promotes the highest standards for endoscopic training and practice, fosters endoscopic research, recognizes distinguished contributions to endoscopy, and is the foremost resource for endoscopic education. Visit Asge.org and ValueOfColonoscopy.org for more information and to find a qualified doctor in your area.

 

American Society for Gastrointestinal Endoscopy
3300 Woodcreek Drive Downers Grove, IL 60515
P (630) 573-0600
F (630) 963-8332

Media Contact

Andrea Lee
Director of Marketing and Communications
630.570.5603
ALee@asge.org