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CMS Releases 2022 HOPPS/ASC Final Rule

CMS Releases 2022 HOPPS/ASC Final Rule

On November 2, the Centers for Medicare & Medicaid Services (CMS) released the calendar year 2022 Hospital Outpatient Prospective Payment System (HOPPS)/Ambulatory Surgery Center (ASC) Payment System final rule. Key provisions affecting otolaryngologist-head and neck surgeons include pausing the elimination of the inpatient-only (IPO) list, reversing changes to the ASC covered procedures list, implementing pass-through payment for HCPCS code J7402 to describe the Sinuva implant, and exceptions to the 2 times rule. Following advocacy efforts and input from the AAO-HNS, CMS revised its proposed policy to remove CPT codes 60512 and 69660 from the ASC covered procedures list. For 2022, each of these procedures will remain on the list of services, which can be performed in an ASC under Medicare. Finalized changes in the rule take effect on January 1, 2022.

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