Rule2024-02631
Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems; Quality Reporting Programs; Payment for Intensive Outpatient Services in Hospital Outpatient Departments, Community Mental Health Centers, Rural Health Clinics, Federally Qualified Health Centers, and Opioid Treatment Programs; Hospital Price Transparency; Changes to Community Mental Health Centers Conditions of Participation, Changes to the Inpatient Prospective Payment System Medicare Code Editor; Rural Emergency Hospital Conditions of Participation Technical Correction; Correction
Primary source
Metadata and text below are from the Federal Register, a public-domain U.S. government work. Always verify the official published version before relying on it for any legal matter.
Published
February 9, 2024
Effective
February 9, 2024
Issuing agencies
Health and Human Services DepartmentCenters for Medicare & Medicaid Services
Abstract
This document corrects technical and typographical errors in the final rule with comment period that appeared in the Federal Register on November 22, 2023, titled "Medicare Program: Hospital Outpatient Prospective Payment and Ambulatory Surgical Center Payment Systems; Quality Reporting Programs; Payment for Intensive Outpatient Services in Hospital Outpatient Departments, Community Mental Health Centers, Rural Health Clinics, Federally Qualified Health Centers, and Opioid Treatment Programs; Hospital Price Transparency; Changes to Community Mental Health Centers Conditions of Participation, Changes to the Inpatient Prospective Payment System Medicare Code Editor; Rural Emergency Hospital Conditions of Participation Technical Correction" (referred to hereafter as the "CY 2024 OPPS/ASC final rule with comment period").
Full Text
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<title>Federal Register, Volume 89 Issue 28 (Friday, February 9, 2024)</title>
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[Federal Register Volume 89, Number 28 (Friday, February 9, 2024)]
[Rules and Regulations]
[Pages 9002-9020]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2024-02631]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
42 CFR Parts 405, 410, 416, 419, 424, 485, 488, and 489
Office of the Secretary
45 CFR Part 180
[CMS-1786-CN]
RIN 0938-AV09
Medicare Program: Hospital Outpatient Prospective Payment and
Ambulatory Surgical Center Payment Systems; Quality Reporting Programs;
Payment for Intensive Outpatient Services in Hospital Outpatient
Departments, Community Mental Health Centers, Rural Health Clinics,
Federally Qualified Health Centers, and Opioid Treatment Programs;
Hospital Price Transparency; Changes to Community Mental Health Centers
Conditions of Participation, Changes to the Inpatient Prospective
Payment System Medicare Code Editor; Rural Emergency Hospital
Conditions of Participation Technical Correction; Correction
AGENCY: Centers for Medicare & Medicaid Services (CMS), Department of
Health and Human Services (HHS).
ACTION: Final rule with comment period; correction.
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SUMMARY: This document corrects technical and typographical errors in
the final rule with comment period that appeared in the Federal
Register on November 22, 2023, titled ``Medicare Program: Hospital
Outpatient Prospective Payment and Ambulatory Surgical Center Payment
Systems; Quality Reporting Programs; Payment for Intensive Outpatient
Services in Hospital Outpatient Departments, Community Mental Health
Centers, Rural Health Clinics, Federally Qualified Health Centers, and
Opioid Treatment Programs; Hospital Price Transparency; Changes to
Community Mental Health Centers Conditions of Participation, Changes to
the Inpatient Prospective Payment System Medicare Code Editor; Rural
Emergency Hospital Conditions of Participation Technical Correction''
(referred to hereafter as the ``CY 2024 OPPS/ASC final rule with
comment period'').
DATES:
Effective Date: This correcting document is effective February 9,
2024.
Applicability Date: This correcting document is applicable January
1, 2024.
FOR FURTHER INFORMATION CONTACT:
Au'Sha Washington via email, <a href="/cdn-cgi/l/email-protection#cb8abeb8a3aae59caab8a3a2a5acbfa4a58ba8a6b8e5a3a3b8e5aca4bd"><span class="__cf_email__" data-cfemail="c283b7b1aaa3ec95a3b1aaabaca5b6adac82a1afb1ecaaaab1eca5adb4">[email protected]</span></a> or at
(410) 786-3736.
Ambulatory Surgical Center (ASC) Payment System, contact Scott
Talaga via email at <a href="/cdn-cgi/l/email-protection#c291a1adb6b6ec96a3aea3a5a382a1afb1ecaaaab1eca5adb4"><span class="__cf_email__" data-cfemail="ecbf8f839898c2b88d808d8b8dac8f819fc284849fc28b839a">[email protected]</span></a> or Mitali Dayal via email
at <a href="/cdn-cgi/l/email-protection#420f2b36232e2b6c06233b232e7002212f316c2a2a316c252d34"><span class="__cf_email__" data-cfemail="35785c4154595c1b71544c545907755658461b5d5d461b525a43">[email protected]</span></a>.
Ambulatory Surgical Center Quality Reporting (ASCQR) Program
policies, contact Anita Bhatia via email at <a href="/cdn-cgi/l/email-protection#e0a18e899481cea28881948981a0838d93ce888893ce878f96"><span class="__cf_email__" data-cfemail="a2e3cccbd6c38ce0cac3d6cbc3e2c1cfd18ccacad18cc5cdd4">[email protected]</span></a>.
Ambulatory Surgical Center Quality Reporting (ASCQR) Program
measures, contact Marsha Hertzberg via email at
<a href="/cdn-cgi/l/email-protection#bfd2decdccd7de91d7dacdcbc5dddacdd8ffdcd2cc91d7d7cc91d8d0c9"><span class="__cf_email__" data-cfemail="bbd6dac9c8d3da95d3dec9cfc1d9dec9dcfbd8d6c895d3d3c895dcd4cd">[email protected]</span></a>.
Hospital Outpatient Quality Reporting (OQR) Program policies,
contact Kimberly Go via email <a href="/cdn-cgi/l/email-protection#d79cbebab5b2a5bbaef990b897b4baa4f9bfbfa4f9b0b8a1"><span class="__cf_email__" data-cfemail="f2b99b9f9097809e8bdcb59db2919f81dc9a9a81dc959d84">[email protected]</span></a>.
Hospital Outpatient Quality Reporting (OQR) Program measures,
contact Janis Grady via email <a href="/cdn-cgi/l/email-protection#7238131c1b015c350013160b32111f015c1a1a015c151d04"><span class="__cf_email__" data-cfemail="baf0dbd4d3c994fdc8dbdec3fad9d7c994d2d2c994ddd5cc">[email protected]</span></a>.
Hospital Price Transparency (HPT) policies, contact Terri Postma
via email <a href="/cdn-cgi/l/email-protection#98c8eaf1fbfdcceaf9f6ebe8f9eafdf6fbe1d0f7ebe8f1ecf9f4dbf0f9eafffdebd8fbf5ebb6f0f0ebb6fff7ee"><span class="__cf_email__" data-cfemail="ebbb9982888ebf998a85989b8a998e858892a384989b829f8a87a8838a998c8e98ab888698c5838398c58c849d">[email protected]</span></a>.
Medicare coverage of opioid use disorder treatment services
furnished by opioid treatment programs, contact Lindsey Baldwin, (410)
786-1694, Ariana Pitcher, (667) 290-8840, or <a href="/cdn-cgi/l/email-protection#105f44404f5d7574797371627550737d633e7878633e777f66"><span class="__cf_email__" data-cfemail="216e75717e6c4445484240534461424c520f4949520f464e57">[email protected]</span></a>.
OPPS Status Indicators (SI) and Comment Indicators (CI), contact
Marina Kushnirova via email at <a href="/cdn-cgi/l/email-protection#db96baa9b2b5baf590aea8b3b5b2a9b4adba9bb8b6a8f5b3b3a8f5bcb4ad"><span class="__cf_email__" data-cfemail="1f527e6d76717e31546a6c7771766d70697e5f7c726c3177776c31787069">[email protected]</span></a>.
Rural Emergency Hospital Quality Reporting (REHQR) Program
policies, contact Anita Bhatia via email at <a href="/cdn-cgi/l/email-protection#fabb94938e9bd4b8929b8e939bba999789d4929289d49d958c"><span class="__cf_email__" data-cfemail="bdfcd3d4c9dc93ffd5dcc9d4dcfdded0ce93d5d5ce93dad2cb">[email protected]</span></a>.
Rural Emergency Hospital Quality Reporting (REHQR) Program
measures, contact Melissa Hager via email <a href="/cdn-cgi/l/email-protection#ce83aba2a7bdbdafe086afa9abbc8eada3bde0a6a6bde0a9a1b8"><span class="__cf_email__" data-cfemail="662b030a0f151507482e0701031426050b15480e0e1548010910">[email protected]</span></a>.
OPPS Data (APC Weights, Conversion Factor, Copayments, Cost-to-
Charge Ratios (CCRs), Data Claims, Geometric Mean Calculation, Outlier
Payments, and Wage Index), contact Erick Chuang via email at
<a href="/cdn-cgi/l/email-protection#afeaddc6ccc481ecc7dacec1c8efccc2dc81c7c7dc81c8c0d9"><span class="__cf_email__" data-cfemail="aaefd8c3c9c184e9c2dfcbc4cdeac9c7d984c2c2d984cdc5dc">[email protected]</span></a>, or Scott Talaga via email at
<a href="/cdn-cgi/l/email-protection#580b3b372c2c760c3934393f39183b352b7630302b763f372e"><span class="__cf_email__" data-cfemail="91c2f2fee5e5bfc5f0fdf0f6f0d1f2fce2bff9f9e2bff6fee7">[email protected]</span></a> or Josh McFeeters via email at
<a href="/cdn-cgi/l/email-protection#0f45607c677a6e21426c496a6a7b6a7d7c4f6c627c2167677c21686079"><span class="__cf_email__" data-cfemail="fab09589928f9bd4b799bc9f9f8e9f8889ba999789d4929289d49d958c">[email protected]</span></a>.
All Other Issues Related to Hospital Outpatient Payments Not
Previously Identified, contact the OPPS mailbox at
<a href="/cdn-cgi/l/email-protection#49063c3d39283d202c273d19191a092a243a6721213a672e263f"><span class="__cf_email__" data-cfemail="347b41404455405d515a40646467745759471a5c5c471a535b42">[email protected]</span></a>.
All Other Issues Related to the Ambulatory Surgical Center Payments
Not Previously Identified, contact the ASC mailbox at
<a href="/cdn-cgi/l/email-protection#aeeffdedfefefdeecdc3dd80c6c6dd80c9c1d8"><span class="__cf_email__" data-cfemail="6223312132323122010f114c0a0a114c050d14">[email protected]</span></a>.
SUPPLEMENTARY INFORMATION:
I. Background
In FR Doc. 2023-24293 of November 22, 2023 (88 FR 81540), there
were a number of technical and typographical errors that are identified
and corrected in this correcting document. The corrections in this
correcting document are effective as if they had been included in the
document that appeared in the November 22, 2023 Federal Register.
Accordingly, the corrections are effective January 1, 2024.
II. Summary of Errors
A. Summary of Errors in the Preamble
1. Hospital Outpatient Prospective Payment System (OPPS) Corrections
On pages 81546, 82156, 82157, and 82158, we are correcting the
estimates of the changes in payments to account for our correction to
apply the trim that we inadvertently failed to apply to claims for the
Hyperbaric Oxygen Therapy APC (APC 5061). When an individual claim
contains 50 or more units on the primary code's line used for
ratesetting, the OPPS ratesetting programs exclude, or trim, these
lines from the calculation of the geometric mean for an ambulatory
payment classification (APC). However, this trim was inadvertently not
included in the ratesetting process for two APCs: Hyperbaric Oxygen
Therapy (APC 5061) and Ancillary Outpatient Services When Patient Dies
(APC 5881). We are applying this trim and removing these lines where
the primary code's units contain 50 or more units for CY 2024 OPPS
ratesetting. The geometric mean cost for APC 5061 will change
significantly as a result of this trim, from what was originally $75.61
to $135.89, because there is a claim for this APC that contained more
than 50 units on an individual line that was originally used in CY 2024
OPPS ratesetting.
In addition, the change in the geometric mean cost for APC 5061
necessitates changing the OPPS weight scalar and OPPS relative payment
weights to maintain budget neutrality for CY 2024, which results in
changes in OPPS payment rates for items and services calculated using
the weight scalar.
On page 81578, we are correcting the weight scalar to use the
updated number calculated after correct application of the trim.
On pages 81592, 81593, and 81595, we are correcting several figures
used in the sample calculations of the full national unadjusted payment
rate, the reduced national unadjusted payment rate, and the adjusted
copayment amount for an APC group to use the
[[Page 9003]]
figures after application of the trim and resulting change in the
payment rates.
On page 81669, we are adding additional language that we
inadvertently omitted regarding HCPCS codes G2066 (Interrogation device
evaluation(s), (remote) up to 30 days; implantable cardiovascular
physiologic monitor system, implantable loop recorder system, or
subcutaneous cardiac rhythm monitor system, remote data acquisition(s),
receipt of transmissions and technician review, technical support and
distribution of results), 93297 (Interrogation device evaluation(s),
(remote) up to 30 days; implantable cardiovascular physiologic monitor
system, including analysis of 1 or more recorded physiologic
cardiovascular data elements from all internal and external sensors,
analysis, review(s) and report(s) by a physician or other qualified
health care professional), and 93298 (Interrogation device
evaluation(s), (remote) up to 30 days; subcutaneous cardiac rhythm
monitor system, including analysis of recorded heart rhythm data,
analysis, review(s) and report(s) by a physician or other qualified
health care professional). Specifically, we are adding language that we
inadvertently omitted stating that the OPPS status indicators for CPT
codes 93297 and 93298 have been revised to indicate that they will be
separately payable under the OPPS.
On page 81801, in the table titled ``Table 95: Skin Substitute
Assignments to High-Cost and Low-Cost Groups for CY 2024'', we are
correcting an inadvertent error in the skin substitute group assignment
for HCPCS code Q4282 (Cygnus dual, per square centimeter) for CY 2023
and CY 2024. HCPCS code Q4282 is assigned to the high-cost skin
substitute group for those years.
2. Ambulatory Surgical Center (ASC) Payment System Corrections
On pages 81958 and 82162, our application of the trim and
correction to the OPPS weight scalar and OPPS relative payment weights,
results in a change to the OPPS payment rates. The revised OPPS payment
rates required an alteration in our estimate of prospective aggregate
ASC expenditures, which in turn necessitates a correction to the ASC
weight scalar and ASC relative payment weights because the ASC Payment
System ratesetting methodology utilizes the scaled OPPS relative
weights. Therefore, we are revising our ASC weight scalar from 0.8881
to 0.889.
3. Hospital Outpatient Quality Reporting (OQR) Program Corrections
On page 81971, we are correcting the Cataracts Visual Function
measure CBE number and endorsement date. Additionally, we are replacing
inadvertently included language that did not pertain to the Cataracts
Visual Function measure with the measure endorsement removal
information.
On page 81993, in the table titled ``Table 128: Finalized Hospital
OQR Program Measure Set for the CY 2026 Payment Determination,'' we are
adding a dagger symbol (``[dagger]'') after the Cataracts Visual
Function measure name, noting that the CBE endorsement for this measure
was removed. We are also adding two double dagger symbols
(``[dagger][dagger]'') both following the COVID-19 Vaccination Among
Health Care Personnel (HCP) measure name in Table 128 and as a table
note following the table to inform readers that the CBE number was
assigned to the original version of the COVID-19 Vaccination Coverage
Among HCP measure but not the modified version of the measure that we
finalized in the CY 2024 OPPS/ASC final rule with comment period.
On page 81994, in the table titled ``Table 129: Finalized Hospital
OQR Program Measure Set for the CY 2027 Payment Determination and
Subsequent Years,'' we are removing inadvertent language related to the
HOPD Procedure Volume measure--a measure that was proposed in the CY
2024 OPPS/ASC proposed rule and not finalized after consideration of
the public comments received--in the table and in the associated table
note following the table. We are also adding a dagger symbol
(``[dagger]'') after the Cataracts Visual Function measure name, noting
that CBE endorsement for this measure was removed. We are also adding
two double dagger symbols (``[dagger][dagger]'') both following the
COVID-19 Vaccination Among Health Care Personnel measure name in Table
129 and as a table note following the table to inform readers that the
CBE number was assigned to the original version of the COVID-19
Vaccination Coverage Among HCP measure but not the modified version of
the measure that we finalized in the CY 2024 OPPS/ASC final rule with
comment period.
4. Ambulatory Surgical Center Quality Reporting Program (ASCQR)
Corrections
On page 82014, we are correcting the citation to the CY 2024 OPPS/
ASC COVID-19 Vaccination Coverage Among HCP measure modification
proposal for the ASCQR Program.
On page 82031, we are correcting the link referenced in footnote
629 and updating the footnote citation accordingly.
On page 82037, in the table titled ``Table 139: Finalized ASCQR
Program Measure Set for the CY 2024 Reporting Period/CY 2026 Payment
Determination'', we are correcting the CBE number for the COVID-19
Vaccination Coverage Among HCP measure. We also are adding two dagger
symbols (``[dagger][dagger]'') following the corrected CBE number for
the COVID-19 Vaccination Among Health Care Personnel measure, and a
related table note following the table associated with the two dagger
symbols, to inform readers that the CBE number was assigned to the
original version of the COVID-19 Vaccination Coverage Among HCP measure
and not the modified version of the measure that we finalized in the CY
2024 OPPS/ASC final rule with comment period.
On page 82038, in table titled ``Table 140: Finalized ASCQR Program
Measure Set for the CY 2025 Payment Determination/CY 2027 Payment
Determination'', we are correcting the CBE numbers for the COVID-19
Vaccination Coverage Among HCP, and the Risk-Standardized Patient-
Reported Outcome-Based Performance Measure (PRO-PM) Following Elective
Primary Total Hip Arthroplasty (THA) and/or Total Knee Arthroplasty
(TKA) in the ASC Setting (THA/TKA PRO-PM) measures. We also are adding
two dagger symbols (``[dagger][dagger]'') following the corrected CBE
number for the COVID-19 Vaccination Among Health Care Personnel
measure, and a related table note following the table associated with
the two dagger symbols, to inform readers that the CBE number was
assigned to the original version of the COVID-19 Vaccination Coverage
Among HCP measure and not the modified version of the measure that we
finalized in the CY 2024 OPPS/ASC final rule with comment period.
On page 82142 through 82148, we inadvertently neglected to carry
over the correct number of ASCs that performed THA/TKA procedures and
the average number of paid Medicare FFS claims for THA/TKA procedures
performed by ASCs in CY 2022, reflected in Table 138, into our burden
calculation estimates. We are correcting the estimates of the number of
ASCs that will perform THA/TKA procedures and the average number of
THA/TKA procedures that will be performed by ASCs for the CY 2025
through 2028 reporting periods as well as the associated burden
estimates for those same reporting periods.
[[Page 9004]]
5. Rural Emergency Health Quality Reporting Program (REHQR) Corrections
On page 82072, in the first full paragraph, first sentence, we
incorrectly stated that REHs would be granted the opportunity to review
their data before the information is published during a 30-day review
and corrections period in our discussion of the preview period policy
and public reporting of quality data generally. We are making
corrections to state that REHs would be granted the opportunity to
preview their data before the information is published during a 30-day
preview period. Similarly, in the following sentence, we are replacing
the current reference to ``preview process'' to ``preview period
policy,'' to make clear that the policy described in this paragraph
would align with that of the Hospital OQR Program. We are also adding
inadvertently omitted language to finalize our policies as proposed
related to public reporting of quality data generally under the REHQR
Program and codifying these policies at Sec. 419.95(f).
On page 82073, we are adding inadvertently omitted language to
finalize our policies as proposed related to public reporting of REHQR
Program claims-based measures.
On page 82074, we are adding inadvertently omitted language to
finalize our policies as proposed related to public reporting of the
Median Time from ED Arrival to ED Departure for Discharged ED Patients
measure.
6. Hospital Price Transparency Corrections
On pages 81545, 82081, 82082, 82084, 82085, 82088, 82097, 82113,
and 82120, we made grammatical and typographical errors.
On page 81547, we made a technical error. Specifically, the summary
language that we included in the CY 2024 OPPS/ASC proposed rule was not
updated to reflect the hospital price transparency regulatory impact
analysis that we included in the CY 2024 OPPS/ASC final rule with
comment period.
On page 82081, we made a technical error in our reference to the
Consolidated Appropriations Act, 2021.
On pages 82099 and 82118, we inadvertently left out the links to
articles referenced in the footnotes which should be included for ease
of access.
On page 82171, we made a technical error in the link included in
footnote 858 such that it does not direct the reader to the article
referenced.
7. Medicare Coverage for Opioid Use Disorder Treatment Services
Corrections Furnished by Opioid Treatment Programs Corrections
On page 81850, in the second full sentence in the third column, the
citations to the CY 2024 Physician Fee Schedule (PFS) final rule are
incorrect and should have instead read 88 FR 79089 through 79093. In
that same sentence, the current policy description is inaccurate. We
are correcting these errors by replacing the sentence with the
following: ``Currently, periodic assessments are allowed to be
furnished via audio-only telecommunication through CY 2023, and in the
CY 2024 PFS final rule (88 FR 79089 through 79093), we finalized that
periodic assessments may be furnished audio-only through the end of CY
2024, to the extent that use of audio-only communications technology is
permitted under the applicable SAMHSA and DEA requirements at the time
the service is furnished, and all other applicable requirements are
met.''
On pages 81854, 81855 and 82162, we are making corrections to the
value of the payment adjustment for IOP services furnished by OTPs due
to technical corrections to the OPPS weight scalar.
B. Summary of Errors in and Corrections to the OPPS and ASC Addenda
Posted on the CMS Website
1. Hospital Outpatient Prospective Payment System (OPPS) Addenda
Summary of Errors
a. Errors in Addendum A
Due to the technical correction to apply a trim to lines for the
primary codes for two APCs, Hyperbaric Oxygen Therapy (APC 5061) and
Ancillary Outpatient Services When Patient Dies (APC 5881), which
remove the resulting excluded claims from CY 2024 OPPS ratesetting,
there is a significant change to the geometric mean cost for APC 5061.
As there is a significant change in the payment rate for APC 5061, we
had to slightly reduce the OPPS weight scalar and relative payment
weights to maintain OPPS budget neutrality. This change results in a
slight reduction in payment rates for other OPPS items and services
calculated using the weight scalar. As a result of the technical
correction to apply the trim and the associated adjustment to the
weight scalar, all payment rates and copayment amounts for items and
services calculated using the weight scalar have changed in Addendum A.
We note that these changes to the OPPS payments and copayments are
minor. The updated file is available online on the CMS website at
<a href="https://www.cms.gov/medicare/payment/prospective-payment-systems/hospital-outpatient">https://www.cms.gov/medicare/payment/prospective-payment-systems/hospital-outpatient</a>.
b. Errors in Addendum B
Due to the technical correction to apply the trim to two APCs,
Hyperbaric Oxygen Therapy (APC 5061) and Ancillary Outpatient Services
When Patient Dies (APC 5881), which remove the resulting excluded
claims from CY 2024 OPPS ratesetting, there is a significant change to
the geometric mean cost for APC 5061. As there is a significant change
in the payment rate for APC 5061, we had to slightly reduce the OPPS
weight scalar and relative payment weights to maintain OPPS budget
neutrality. This change results in a slight reduction in payment rates
for other OPPS items and services calculated using the weight scalar.
This correction will require minor changes to most payment and
copayment rates in Addendum B. The updated file is available online on
the CMS website at <a href="https://www.cms.gov/medicare/payment/prospective-payment-systems/hospital-outpatient">https://www.cms.gov/medicare/payment/prospective-payment-systems/hospital-outpatient</a>.
We inadvertently failed to account for the cost of a device that is
an integral part of the kidney histotripsy procedure in our assignment
of HCPCS code C9790 (Histotripsy (i.e., non-thermal ablation via
acoustic energy delivery) of malignant renal tissue, including image
guidance) to APC 1575, which has payment rate of $12,500.50 and a
minimum unadjusted copayment of $2,500.10. We failed to include the
cost of the device for the kidney histotripsy procedure in the payment
rate that we reported for HCPCS code C9790 in the CY 2024 OPPS/ASC
final rule. To correct this error, we are assigning HCPCS code C9790 to
the APC with a payment rate that includes the device cost for the
kidney histotripsy procedure--APC 1576--with a payment rate of
$17,500.50 and a minimum unadjusted copayment of $3,500.10.
We incorrectly assigned status indicator ``E1'' to CPT code 90623
(Meningococcal pentavalent vaccine, conjugated Men A, C, W, Y- tetanus
toxoid carrier, and Men B-FHbp, for intramuscular use), meaning the
code is not covered by Medicare, even though the meningococcal vaccine
has approval from the Food and Drug Administration (FDA). We are
correcting the error by changing the status indicator from ``E1'' to
``M,'' to indicate that the code is not paid under the OPPS.
We incorrectly assigned HCPCS code A9272 (Wound suction,
disposable, includes dressing, all accessories and components, any
type, each) status indicator ``E1'' to indicate that the code
[[Page 9005]]
is not covered by Medicare, even though this code is payable under the
Home Health Prospective Payment System (HH PPS) effective January 1,
2024. We are correcting this error by changing the status indicator
from ``E1'' to ``A'' to indicate that the code is payable under a fee
schedule or payment system other than the OPPS.
We incorrectly listed HCPCS code C7561 (Debridement, bone (includes
epidermis, dermis, subcutaneous tissue, muscle and/or fascia, if
performed); first 20 sq cm or less with manual preparation and
insertion of drug-delivery device(s), deep (e.g., subfascial)) as an
active code with an OPPS status indicator of ``E1'' to indicate that
the code is an ASC-only code that is not separately payable under the
OPPS because the combined service, as described by the code, is not
reasonable and necessary. However, this code already exists as HCPCS
code C7500 (Debridement, bone including epidermis, dermis, subcutaneous
tissue, muscle and/or fascia, if performed, first 20 sq cm or less with
manual preparation and insertion of deep (e.g., subfacial) drug-
delivery device(s)), and therefore this service does not require a new
HCPCS code. Consequently, we are deleting HCPCS code C7561 and will not
be establishing the code for the January 2024 update.
We inadvertently assigned CPT code 96202 (Multiple-family group
behavior management/modification training for parent(s)/guardian(s)/
caregiver(s) of patients with a mental or physical health diagnosis,
administered by physician or other qualified health care professional
(without the patient present), face-to-face with multiple sets of
parent(s)/guardian(s)/caregiver(s); initial 60 minutes) a status
indicator of ``E1,'' which indicates that the code is not covered by
Medicare, even though this code is payable in settings other than the
outpatient hospital setting. We also incorrectly assigned CPT code
96203 (Multiple-family group behavior management/modification training
for parent(s)/guardian(s)/caregiver(s) of patients with a mental or
physical health diagnosis, administered by physician or other qualified
health care professional (without the patient present), face-to-face
with multiple sets of parent(s)/guardian(s)/caregiver(s); each
additional 15 minutes (list separately in addition to code for primary
service)) a status indicator of ``N,'' which means that a service is
payable in the OPPS but its cost is packaged into an associated primary
service, because CPT code 96203 is an add-on code that is billed with
CPT code 96202. However, an add-on service cannot have a payable status
in the OPPS when its associated primary service has a non-payable
status in the OPPS. These services are covered Medicare services and
are assigned payable indicators under the Physician Fee Schedule (PFS).
While these services are not payable under OPPS, they are payable under
the PFS; therefore, we are correcting the status indicator to ``A.''
c. Errors in Addendum C
Due to the technical correction to apply a trim to two APCs,
Hyperbaric Oxygen Therapy (APC 5061) and Ancillary Outpatient Services
When Patient Dies (APC 5881) and removing the resulting excluded claims
from CY 2024 OPPS ratesetting, there is a significant change to the
geometric mean cost for APC 5061. As there is a significant change in
the payment rate for APC 5061, we had to slightly reduce the OPPS
weight scalar and relative payment weights to maintain OPPS budget
neutrality. This change results in a slight reduction in payment rates
for other OPPS items and services calculated using the weight scalar.
This correction will require minor changes to most payment and
copayment rates in Addendum C. The updated file is available online on
the CMS website at <a href="https://www.cms.gov/medicare/payment/prospective-payment-systems/hospital-outpatient">https://www.cms.gov/medicare/payment/prospective-payment-systems/hospital-outpatient</a>.
We inadvertently failed to consider the cost of a device that is an
integral part of the kidney histotripsy procedure when we assigned
HCPCS code C9790 to APC 1575, which has payment rate of $12,500.50 and
a minimum unadjusted copayment of $2,500.10. We failed to include the
cost of the device for the kidney histotripsy procedure in the payment
rate that we reported for HCPCS code C9790 in the CY 2024 OPPS/ASC
final rule with comment period. To correct this error, we are assigning
HCPCS code C9790 to the APC with a payment rate that includes the
device cost for the kidney histotripsy procedure--APC 1576--with a
payment rate of $17,500.50 and a minimum unadjusted copayment of
$3,500.10.
d. Errors in Addendum P
Due to the technical correction to apply a trim to lines for the
primary codes for two APCs, Hyperbaric Oxygen Therapy (APC 5061) and
Ancillary Outpatient Services When Patient Dies (APC 5881), which
remove the resulting excluded claims from CY 2024 OPPS ratesetting,
there is a significant change to the geometric mean cost for APC 5061.
As there is a significant change in the payment rate for APC 5061, we
had to slightly reduce the OPPS weight scalar and relative payment
weights to maintain OPPS budget neutrality. This change results in a
slight reduction in payment rates for other OPPS items and services
calculated using the weight scalar. The device offset amounts displayed
in Addendum P are calculated by multiplying the OPPS APC payment rate
by a procedure's device offset percentage, and therefore the correction
to OPPS APC payment rates affects the affects the device offset amounts
for any affected APCs. Therefore, we have recalculated the device
offset amounts for both device-intensive and non-device-intensive
procedures in Addendum P.
To view the corrected CY 2024 OPPS status indicators, APC
assignments, relative weights, payment rates, copayment rates, device-
intensive status, and short descriptors for Addenda A, B, C, and P that
resulted from the technical corrections described in this correcting
document, we refer readers to the Addenda and supporting files that are
posted on the CMS website at: <a href="https://www.cms.gov/medicare/payment/prospective-payment-systems/hospital-outpatient/">https://www.cms.gov/medicare/payment/prospective-payment-systems/hospital-outpatient/</a>. Select ``CMS-1786-
CN'' from the list of regulations. All corrected Addenda for this
correcting document are contained in the zipped folder titled ``2024
OPPS Final Rule Addenda'' at the bottom of the page for CMS-1786-CN.
2. Ambulatory Surgical Center (ASC) Payment System Addenda Summary of
Errors
a. Errors in Addendum AA
Due to the technical correction to apply a trim to lines for the
primary codes for two APCs, Hyperbaric Oxygen Therapy (APC 5061) and
Ancillary Outpatient Services When Patient Dies (APC 5881), which
remove the resulting excluded claims from CY 2024 OPPS ratesetting,
there is a significant change to the geometric mean cost for APC 5061.
As there is a significant change in the payment rate for APC 5061, we
had to slightly reduce the OPPS weight scalar and relative payment
weights to maintain OPPS budget neutrality. This change results in a
slight reduction in payment rates for other OPPS items and services
calculated using the weight scalar. The correction to apply the trim to
APC 5061 and the resulting change to the OPPS weight scalar, OPPS
relative payment weights, and OPPS payment rates necessitate a revision
to the CY 2024 ASC weight scalar and ASC payment rates, which results
in changes in the columns titled ``Final CY 2024
[[Page 9006]]
Payment Weight'' and ``Final CY 2024 Payment Rate'' in Addendum AA to
separately paid covered surgical procedures that are not paid at the
PFS-equivalent rate.
We inadvertently failed to account for the cost of a device that is
an integral part of the kidney histotripsy procedure when establishing
a payment rate for HCPCS code C9790 (Histotripsy (i.e., non-thermal
ablation via acoustic energy delivery) of malignant renal tissue,
including image guidance), which has a payment weight of 127.0479 and a
payment rate of $6,798.84. However, we failed to include the cost of
the device for the kidney histotripsy procedure in the payment rate
that we reported for HCPCS code C9790 in the CY 2024 OPPS/ASC final
rule. To correct this error, we are replacing the payment weight of
127.0479 and the payment rate of $6,798.84 with the payment weight of
177.8649 and the payment rate of $9,527.91, respectively, for HCPCS
code C9790 in Addendum AA.
We inadvertently omitted CPT code 0810T (Subretinal injection of a
pharmacologic agent, including vitrectomy and 1 or more retinotomies)
from Addendum AA. As we explained in pages 81617 through 81618 of the
CY 2024 OPPS/ASC final rule with comment period, CPT code 0810T is
replacing HCPCS code C9770. We are correcting this error in Addendum AA
by adding CPT code 0810T (Subretinal injection of a pharmacologic
agent, including vitrectomy and 1 or more retinotomies).
We inadvertently created HCPCS code C7561 (Debridement, bone
(includes epidermis, dermis, subcutaneous tissue, muscle and/or fascia,
if performed); first 20 sq cm or less with manual preparation and
insertion of drug-delivery device(s), deep (e.g., subfascial) to
describe the code pair combination of CPT code 11044 (Debridement, bone
(includes epidermis, dermis, subcutaneous tissue, muscle and/or fascia,
if performed); first 20 sq cm or less) and CPT code 20700 (Manual
preparation and insertion of drug-delivery device(s), deep (e.g.,
subfascial) (list separately in addition to code for primary
procedure). This code pair currently exists as HCPCS code C7500
(Debridement, bone including epidermis, dermis, subcutaneous tissue,
muscle and/or fascia, if performed, first 20 sq cm or less with manual
preparation and insertion of deep (e.g., subfacial) drug-delivery
device(s)). Because C7500 already describes this code pair, this code
pair does not require a new HCPCS code. We are correcting this error in
Addenda AA and FF by adding HCPCS code C7500 and removing HCPCS code
C7561.
On page 81922 of the CY 2024 OPPS/ASC final rule with comment
period, we stated we would finalize a device-intensive assignment with
the default device offset percentage of 31 percent and assign a payment
indicator of ``J8'' to HCPCS code C9734 (Focused ultrasound ablation/
therapeutic intervention, other than uterine leiomyomata, with magnetic
resonance (mr) guidance) for CY 2024; however, in Addendum AA, we
inadvertently assigned a payment indicator of ``G2'' to this code.
Therefore, in Addendum AA, in the column titled ``CY 2024 Payment
Indicator,'' we are replacing payment indicator ``G2'' with payment
indicator ``J8''--Device-intensive procedure; paid at adjusted rate--
and are revising the ASC payment weight and payment rate to 152.9811
and $8,186.63, respectively.
On page 81921 of the CY 2024 OPPS/ASC final rule with comment
period, we stated we are finalizing our proposed device offset amounts
for CPT code 58356, which exceeded our device-intensive threshold of 30
percent and to which we assigned device-intensive status and a payment
indicator of ``J8''--Device-intensive procedure; paid at adjusted rate.
However, in Addendum AA, we inadvertently assigned a payment indicator
of ``G2'' to this code. Therefore, in Addendum AA, we are correcting
the payment indicator in the column titled ``CY 2024 Payment
Indicator'' to ``J8'' and are revising the payment weight and payment
rate to 62.4392 and $3,341.37, respectively.
We inadvertently assigned CPT codes 0266T and 0620T and HCPCS code
C9790 a discounting status of ``Y'' (Yes) in the column titled
``Subject to Multiple Procedure Discounting''. Our multiple procedure
discounting logic assigns a discounting status of ``N'' (No) to
procedures with a status indicator ``S,'' which indicates that the
procedure or service is separately paid and is not subject to multiple
procedure discounting under the OPPS. We assigned CPT codes 0266T and
0620T and HCPCS code C9790 to status indicator ``S'' in OPPS Addendum B
for CY 2024, and therefore, these codes should have a discounting
status of ``N'' based on our multiple procedure discounting policy (72
FR 42513 through 42516). Therefore, we are correcting this error by
deleting ``Y'' (Yes) and inserting ``N'' (No) in the column titled
``Subject to Multiple Procedure Discounting,'' indicating that the
procedure is not subject to multiple procedure discounting, for CPT
codes 0266T and 0620T and HCPCS code C9790.
b. Errors in Addendum BB
The correction to apply the trim to APC 5061 and the resulting
change to the OPPS weight scalar and OPPS payment rates, necessitate a
revision to the CY 2024 ASC weight scalar and ASC payment rates for
certain separately paid ancillary procedures that are not paid at the
PFS-equivalent rate. The correction to the ASC weight scalar and OPPS
payment rates result in changes in the columns titled ``Final CY 2024
Payment Weight'' and ``Final CY 2024 Payment Rate'' in Addendum BB to
separately paid ancillary procedures that are not paid at the PFS-
equivalent rate.
We inadvertently assigned payment indicator ``J7''--OPPS pass-
through device paid separately when provided integral to a surgical
procedure on ASC list; payment contractor-priced--to both HCPCS codes
C1831 (Interbody cage, anterior, lateral or posterior, personalized
(implantable)) and C1604 (Graft, transmural transvenous arterial bypass
(implantable), with all delivery system components) as both these
devices are approved OPPS pass-through devices for CY 2024. However,
these devices are not separately payable under the ASC payment system
for CY 2024. Accordingly, we are correcting these errors in Addendum BB
by deleting ``J7'' in the column titled ``Final CY 2024 Payment
Indicator'' and replacing it with ``N1''--Packaged service/item; no
separate payment made for both HCPCS codes C1831 and C1604.
b. Errors in Addendum FF
The correction to apply the trim to APC 5061 and the resulting
change to the OPPS weight scalar and OPPS payment rates, necessitate a
revision to the CY 2024 ASC weight scalar, ASC relative payment
weights, and ASC payment rates and the device offset amounts/device
portions for device-intensive procedures because device offset amounts
are held at the OPPS rate (i.e., the OPPS payment rate multiplied by
the device offset percentage) for device-intensive procedures. Further,
the correction to the ASC weight scalar necessitates a correction to
ASC payment rates, which requires a correction to the device offset
amounts/device portions for non device-intensive procedures because the
device offset amounts are held at the ASC rate (i.e., the ASC payment
rate multiplied by the device offset percentage) for these procedures.
We inadvertently omitted CPT code 0810T (Subretinal injection of a
pharmacologic agent, including
[[Page 9007]]
vitrectomy and 1 or more retinotomies) from Addendum FF. As we
explained in pages 81617 through 81618 of the CY 2024 OPPS/ASC final
rule with comment period, we finalized our proposal to delete HCPCS
code C9770 and reassign CPT code 0810T to APC 1563. We are correcting
this error by adding CPT code 0810T to Addendum FF.
We inadvertently created HCPCS code C7561 (Debridement, bone
(includes epidermis, dermis, subcutaneous tissue, muscle and/or fascia,
if performed); first 20 sq cm or less with manual preparation and
insertion of drug-delivery device(s), deep (e.g., subfascial) to
describe the code pair combination of CPT code 11044 (Debridement, bone
(includes epidermis, dermis, subcutaneous tissue, muscle and/or fascia,
if performed); first 20 sq cm or less) and CPT code 20700 (Manual
preparation and insertion of drug-delivery device(s), deep (e.g.,
subfascial) (list separately in addition to code for primary
procedure). This code pair currently exists as HCPCS code C7500
(Debridement, bone including epidermis, dermis, subcutaneous tissue,
muscle and/or fascia, if performed, first 20 sq cm or less with manual
preparation and insertion of deep (e.g., subfacial) drug-delivery
device(s)). Since this code pair currently is already reflected in
C7500, this code pair does not require a new HCPCS code. We are
correcting this error by deleting HCPCS code C7561 and adding HCPCS
code C7500.
On page 81922 of the CY 2024 OPPS/ASC final rule with comment
period, we stated we would finalize a device-intensive assignment with
the default device offset percentage of 31 percent to HCPCS code C9734
(Focused ultrasound ablation/therapeutic intervention, other than
uterine leiomyomata, with magnetic resonance (mr) guidance) for CY
2024; however, we inadvertently assigned a payment indicator of
``G2''--Non office-based surgical procedure added in CY 2008 or later;
payment based on OPPS relative payment weight--to HCPCS code C9734 in
Addendum FF. Therefore, we are correcting the payment indicator in the
column titled ``Final CY 2024 Payment Indicator'' for C9734 to ``J8''--
device-intensive procedure; paid at adjusted rate. We are also
correcting the device offset percentage in the column titled ``Final CY
2024 Device Offset Percentage'' to 31 percent, and the device offset
amount in the column titled ``Final CY 2024 Device Offset Amount/Device
Portion'' to $3,701.33.
We inadvertently provided incorrect device offset amounts for CPT
codes 0627T (Percutaneous injection of allogeneic cellular and/or
tissue-based product, intervertebral disc, unilateral or bilateral
injection, with fluoroscopic guidance, lumbar; first level); 0671T
(Insertion of anterior segment aqueous drainage device into the
trabecular meshwork, without external reservoir, and without
concomitant cataract removal, one or more); 31295 (Nasal/sinus
endoscopy, surgical, with dilation (e.g., balloon dilation); maxillary
sinus ostium, transnasal or via canine fossa); 58356 (Endometrial
cryoablation with ultrasonic guidance, including endometrial curettage,
when performed); 66989 (Extracapsular cataract removal with insertion
of intraocular lens prosthesis (1-stage procedure), manual or
mechanical technique (e.g., irrigation and aspiration or
phacoemulsification), complex, requiring devices or techniques not
generally used in routine cataract surgery (e.g., iris expansion
device, suture support for intraocular lens, or primary posterior
capsulorrhexis) or performed on patients in the amblyogenic
developmental stage; with insertion of intraocular (e.g., trabecular
meshwork, supraciliary, suprachoroidal) anterior segment aqueous
drainage device, without extraocular reservoir, internal approach, one
or more); and 66991 (Extracapsular cataract removal with insertion of
intraocular lens prosthesis (1 stage procedure), manual or mechanical
technique (e.g., irrigation and aspiration or phacoemulsification);
with insertion of intraocular (e.g., trabecular meshwork, supraciliary,
suprachoroidal) anterior segment aqueous drainage device, without
extraocular reservoir, internal approach, one or more) and HCPCS codes
C9757 (Laminotomy (hemilaminectomy), with decompression of nerve
root(s), including partial facetectomy, foraminotomy and excision of
herniated intervertebral disc, and repair of annular defect with
implantation of bone anchored annular closure device, including annular
defect measurement, alignment and sizing assessment, and image
guidance; 1 interspace, lumbar) and C9781 (Arthroscopy, shoulder,
surgical; with implantation of subacromial spacer (e.g., balloon),
includes debridement (e.g., limited or extensive), subacromial
decompression, acromioplasty, and biceps tenodesis when performed).
On page 81921 of the CY 2024 OPPS/ASC final rule with comment
period, we stated we are finalizing our proposed device offset
percentages for these codes and displayed the final device offset
percentages in Addendum FF to CY 2024 OPPS/ASC final rule with comment
period. However, the device offset percentages in the addendum do not
reflect these finalized device offset amounts. Therefore, we are
correcting the device offset percentage in the column titled ``Final CY
2024 Device Offset Percentage,'' and we are correcting the device
offset amount in the column titled ``Final CY 2024 Device Offset
Amount/Device Portion.'' Further, for CPT code 58356, the corrected
device offset percentage is above our device-intensive threshold and we
are therefore assigning device-intensive status to CPT code 58356. In
the column titled ``CY 2024 Payment Indicator,'' for CPT code 58356, we
are replacing payment indicator ``G2'' with payment indicator ``J8''--
Device-intensive procedure; paid at adjusted rate.
To view the corrected final CY 2024 ASC payment indicators, payment
weights, payment rates, and multiple procedure discounting indicators
for Addenda AA, BB, and FF that resulted from these technical
corrections, we refer readers to the Addenda and supporting files on
the CMS website at: <a href="https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/ASCPayment/ASC-Regulations-and-Notices.html">https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/ASCPayment/ASC-Regulations-and-Notices.html</a>. Select
``CMS-1786-CN'' from the list of regulations. All corrected ASC addenda
for this correcting document are contained in the zipped folder
entitled ``Addendum AA, BB, and FF'' at the bottom of the page for CMS-
1786-CN.
III. Waiver of Proposed Rulemaking and Delay in Effective Date
Under 5 U.S.C. 553(b) of the Administrative Procedure Act (APA),
the agency is required to publish a notice of the proposed rulemaking
in the Federal Register before the provisions of a rule take effect.
Similarly, section 1871(b)(1) of the Act requires the Secretary to
provide for notice of the proposed rulemaking in the Federal Register
and provide a period of not less than 60 days for public comment. In
addition, section 553(d) of the APA, and section 1871(e)(1)(B)(i) of
the Act mandate a 30-day delay in effective date after issuance or
publication of a rule. Sections 553(b)(B) and 553(d)(3) of the APA
provide for exceptions from the notice and comment and delay in
effective date APA requirements; in cases in which these exceptions
apply, sections 1871(b)(2)(C) and 1871(e)(1)(B)(ii) of the Act provide
exceptions from the notice and 60-day comment period and delay in
effective date requirements of the Act as well. Section 553(b)(B) of
the APA
[[Page 9008]]
and section 1871(b)(2)(C) of the Act authorize an agency to dispense
with normal rulemaking requirements for good cause if the agency makes
a finding that the notice and comment process are impracticable,
unnecessary, or contrary to the public interest. In addition, both
section 553(d)(3) of the APA and section 1871(e)(1)(B)(ii) of the Act
allow the agency to avoid the 30-day delay in effective date where such
delay is contrary to the public interest and an agency includes a
statement of support. We believe that this correction does not
constitute a rule that would be subject to the notice and comment or
delayed effective date requirements. This correcting document corrects
technical and typographical errors in the preamble, addenda, payment
rates, and tables included or referenced in the CY 2024 OPPS/ASC final
rule with comment period but does not make substantive changes to the
policies or payment methodologies that were adopted in the CY 2024
OPPS/ASC final rule with comment period. As a result, this correction
is intended to ensure that the information in the CY 2024 OPPS/ASC
final rule with comment period accurately reflects the policies adopted
in that document.
In addition, even if this were a rule to which the notice and
comment procedures and delayed effective date requirements applied, we
find that there is good cause to waive such requirements. Undertaking
further notice and comment procedures to incorporate the corrections in
this document into the final rule with comment period or delaying the
effective date would be contrary to the public interest because it is
in the public's interest for providers to receive appropriate payments
in as timely a manner as possible, and to ensure that the CY 2024 OPPS/
ASC final rule with comment period reflects our policies. Furthermore,
such procedures would be unnecessary, as we are not altering our
payment methodologies or policies, but rather, we are simply correctly
implementing the policies that we previously proposed, requested
comment on, and subsequently finalized. This correcting document is
intended solely to ensure that the CY 2024 OPPS/ASC final rule with
comment period accurately reflects these payment methodologies and
policies. For these reasons, we believe we have good cause to waive the
notice and comment and delayed effective date requirements.
Moreover, even if these corrections were considered to be
retroactive rulemaking, they would be authorized under section
1871(e)(1)(A)(ii) of the Act, which permits the Secretary to issue a
rule for the Medicare program with retroactive effect if the failure to
do so would be contrary to the public interest. As we have explained
previously, we believe it would be contrary to the public interest not
to implement the corrections in this final rule correction because it
is in the public's interest for providers to receive appropriate
payments in as timely a manner as possible, and to ensure that the CY
2024 OPPS/ASC final rule with comment period accurately reflects our
policies.
IV. Correction of Errors
In FR Doc. 2023-24293 of November 22, 2023 (88 FR 81540), we are
making the following corrections:
1. On page 81545, third column, first partial bulleted paragraph,
lines 44 and 45, the phrase ``(5) a requirement that hospitals to
include a .txt file'' is corrected to read ``(5) a requirement that
hospitals include a .txt file''.
2. On page 81546,
a. Second column, last partial paragraph, line 12, the figure
``9.2'' is corrected to read ``9.1''.
b. Third column, first full paragraph, line 4, the figure ``0.0''
is corrected to read ``0.1''.
3. On page 81547, first column, the paragraph under ``f. Impacts of
Hospital Price Transparency'' is corrected in its entirety to read,
``The policies we are finalizing to enhance automated access to
hospital MRFs and aggregation and use of MRF data are estimated to
increase burden on hospitals, including a one-time mean of $10,587.10
per hospital, and a total national cost of $75,147,236 ($10,587.10 x
7,098). The cost estimate reflects estimated costs ranging from $4,833
and $15,881 per hospital, and a total national cost ranging from
$34,305,344 to $112,720,854. As discussed in detail in section XXVI of
this final rule with comment period, we believe that the benefits to
the public (and to hospitals themselves) outweigh the burden imposed on
hospitals.''.
4. On page 81578, first column, first full paragraph, line 5, the
figure ``1.4429'' is corrected to read ``1.4414''.
5. On page 81592, third column,
a. Last paragraph under the heading ``Step 7'',
(1) Line 17, the figure ``$671.05'' is corrected to read
``$670.36''.
(2) Line 21, the figure $658.03''is corrected to read ``$657.36''.
b. Last paragraph,
(1) Line 3, the figure ``$402.63'' is corrected to read
``$402.22''.
(2) Line 4, the figure ``$671.05'' is corrected to read
``$670.36''.
(3) Line 6, the figure ``$394.82'' is corrected to read
``$394.42''.
(4) Line 7, the figure ``$658.03'' is corrected to read
``$657.36''.
6. On page 81593,
a. First column, second paragraph, line 4, the equation ``$546.05
($402.63 *1.3562)'' is corrected to read ``$545.49 ($402.22 *
1.3562)''.
b. Second column,
(1) First partial paragraph, line 1, the figures ``$535.45
($394.82'' are corrected to read ``$534.91 ($394.42''.
(2) First full paragraph,
(a) Line 3, the figure ``$268.42'' is corrected to read
``$268.14''.
(b) Line 4, the figure ``$671.05'' is corrected to read
``$670.36''.
(c) Line 6, the figure ``$263.21'' is corrected to read
``$262.94''.
(d) Line 7, the figure ``$658.03'' is corrected to read
``$657.36''.
c. Third column, first full paragraph,
(1) Line 4, the figures ``$814.47 ($546.05'' are corrected to read
``$813.63 ($545.49''.
(2) Line 5, the figure ``$268.42'' is corrected to read
``$268.14''.
(3) Line 7, the figures ``$798.66 ($535.45'' are corrected to read
$797.85 ($534.91''.
(4) Line 8, the figure ``$263.21'' is corrected to read
``$262.94''.
(d) The table titled ``Table 7: Final Full National Unadjusted
Payment Rate and Final Reduced National Adjusted Payment Rate,'' which
appears near the top of the page, is corrected to read as follows:
BILLING CODE 4120-01-P
[GRAPHIC] [TIFF OMITTED] TR09FE24.005
[[Page 9009]]
7. On page 81595, third column, second full paragraph,
a. Line 5, the figure ``$134.21'' is corrected to read ``$134.08''.
b. Line 8, the figure ``$671.05'' is corrected to read ``$670.36''.
8. On page 81669, third column, first full paragraph, line 7,
before the sentence that reads ``In addition, we did not receive any
comments on our proposed APC assignment for CPT code 93296.'', add the
following paragraph: ``Additionally, as noted by the commenter, CPT
codes 93297 and 93298 have been assigned to direct practice inputs
under the PFS for 2024. However, while not mentioned by the commenter,
these codes have also been designated with a global, technical, and
professional indicators under the PFS for 2024. As stated in the 2024
PFS final rule (88 FR 78914), CPT code 93297 and 93298 were previously
billed under HCPCS code G2066. We note that under the OPPS, HCPCS code
G2066 was assigned to status indicator ``Q1'' (STV-Packaged Codes) and
APC 5741 (Level 1 Electronic Analysis of Devices). Since G2066 was the
code previously reported for CPT codes 93297 and 93298, we are
assigning these codes to separately payable status under the OPPS for
CY 2024. Specifically, we are assigning CPT codes 93297 and 93298 to
``Q1'' and APC 5741 effective January 1, 2024.''.
9. On page 81801, in the table titled ``Table 95: Skin Substitute
Assignments to High-Cost and Low-Cost Groups for CY 2024, in the row
for HCPCS code Q4282 in the columns titled ``CY 2023 High/Low Cost
Assignment'' and ``CY 2024 High/Low Cost Assignment'' the entries
``Low'' are corrected to read ``High''.
10. On page 81850, third column, first partial paragraph, lines 18
through 31, that reads ``Currently, periodic assessments are allowed to
be furnished via audio-only telecommunication through CY 2023, and
finalized in the CY 2024 PFS final rule (87 FR 69404; November 18,
2023) so that these services may be furnished audio-only through the
end of CY 2024, to the extent that use of audio-only communications
technology is permitted under the applicable SAMHSA and DEA
requirements at the time the service is furnished, and all other
applicable requirements are met.'' are corrected to read ``Currently,
periodic assessments are allowed to be furnished via audio-only
telecommunication through CY 2023, and in the CY 2024 PFS final rule
(88 FR 79089 through 79093), we finalized that periodic assessments may
be furnished audio-only through the end of CY 2024, to the extent that
use of audio-only communications technology is permitted under the
applicable SAMHSA and DEA requirements at the time the service is
furnished, and all other applicable requirements are met.''.
11. On page 81854, second column, first partial paragraph, line 30,
the figure ``$778.20'' is corrected to read ``$777.39.''
12. On page 81855, second column,
a. Second full paragraph,
(1) Line 31, the figure ``$259.40'' is corrected to read
``$259.13''.
(2) Line 35, the figure ``$778.20'' is corrected to read
``$777.39''.
b. In footnote 188, line 6, the figure ``$259.40'' is corrected to
read ``$259.13''.
13. On page 81958,
a. Second column, last partial paragraph, line 7, the figure
``0.8881'' is corrected to read ``0.889''.
b. Third column, first full paragraph, line 8, the figure
``0.8881'' is corrected to read ``0.889''.
14. On page 81971, first column, first partial paragraph,
a. Line 20, the figure ``3636'' is corrected to read ``1536''.
b. Lines 20 through 21, the text ``July 26, 2022. The measure
steward (CDC) is pursuing endorsement for the modified version of this
measure.'' is corrected to read ``January 31, 2012. This measure's
endorsement was removed in 2018.''.
15. On page 81993, in the table titled ``Table 128: Finalized
Hospital OQR Program Measure Set for the CY 2026 Payment
Determination'',
a. Row 9, column 2, the text ``Cataracts Visual Function
(Previously referred to as Cataracts: Improvement in Patient's Visual
Function within 90 Days Following Cataract Surgery) **'' is corrected
to read ``Cataracts Visual Function (Previously referred to as
Cataracts: Improvement in Patient's Visual Function within 90 Days
Following Cataract Surgery)[dagger]**''.
b. Row 18, the text ``COVID-19 Vaccination Coverage Among Health
Care Personnel ****'' is corrected to read ``COVID-19 Vaccination
Coverage Among Health Care Personnel [dagger][dagger]****'',
c. Adding the following table note ``[dagger][dagger] This CBE
endorsement number was assigned to the original version of the COVID-19
Vaccination Coverage Among Health Care Personnel measure and not the
finalized modification of the measure we are finalizing in this rule.''
after the first table note ([dagger]We note that CBE endorsement for
this measure was removed.) and before the second table note ``* In this
final rule, we are finalizing our proposal to modify the Colonoscopy
Follow-Up Interval measure beginning with the CY 2024 reporting period/
CY 2026 payment determination.''.
16. On page 81994, the table titled ``Table 129: Finalized Hospital
OQR Program Measure Set for the CY 2027 Payment Determination and
Subsequent Years'', is corrected to read as follows:
BILLING CODE 4120-01-P
[[Page 9010]]
[GRAPHIC] [TIFF OMITTED] TR09FE24.006
17. On page 82014, second column, first partial paragraph, lines 1
and 2, the citation ``(88 FR 49774 through 49776)'' is corrected to
read ``(88 FR 49805 through 49807)''.
18. On page 82031, first partial footnoted paragraph (footnote
629), ``Centers for Medicare and Medicaid Services Measures Inventory
Tool. (n.d.). Retrieved March 28, 2023, from <a href="https://cmit.cms.gov/cmit/#/MeasureView?variantId=11547§ionNumber=1">https://cmit.cms.gov/cmit/#/MeasureView?variantId=11547§ionNumber=1</a>'' is corrected to read:
``Centers for Medicare and Medicaid Services Measures Inventory Tool.
(n.d.). Retrieved November 30, 2023, from <a href="https://cmit.cms.gov/cmit/#/MeasureView?variantId=11625§ionNumber=1">https://cmit.cms.gov/cmit/#/MeasureView?variantId=11625§ionNumber=1</a>''.
19. On page 82037, in the table titled ``Table 139: Finalized ASCQR
Program Measures Set for the CY 2024 Reporting Period/CY 2026 Payment
Determination'',
a. The entry for row 14 is corrected to read as follows:
[GRAPHIC] [TIFF OMITTED] TR09FE24.007
[[Page 9011]]
BILLING CODE 4120-01-C
b. Add the following table note ``[dagger][dagger] This CBE
endorsement number was assigned to the original version of the COVID-19
Vaccination Coverage Among Health Care Personnel measure and not the
modification of the measure we are finalizing in this rule.'' after the
first table note ([dagger] CBE endorsement was removed.) and before the
second table note (* In the CY 2023 OPPS/ASC final rule with comment
period (87 FR 72118 through 72120), we finalized to keep data
collection and submission voluntary for this measure for the CY 2025
reporting period and subsequent years. In this final rule, we are
finalizing our proposal to standardize the surveys offered to patients
pre- and post-surgery beginning with the CY 2024 reporting period/CY
2026 payment determination.).
20. On page 82038, in the table titled ``Table 140: Finalized ASCQR
Program Measure Set for the CY 2025 Reporting Period/CY 2027 Payment
Determination'',
a. The entries for rows 20 and 21 are corrected to read as follows:
[GRAPHIC] [TIFF OMITTED] TR09FE24.008
b. Add the following table note ``[dagger][dagger] This CBE
endorsement number was assigned to the original version of the COVID-19
Vaccination Coverage Among Health Care Personnel measure and not the
modification of the measure we are finalizing in this rule.'' after the
first table note ([dagger] CBE endorsement was removed.) and before the
second table note (* In the CY 2023 OPPS/ASC final rule with comment
period (87 FR 72118 through 72120), we finalized to keep data
collection and submission voluntary for this measure for the CY 2025
reporting period and subsequent years.).
21. On page 82072,
a. First column, first full paragraph,
(1) Lines 3 and 4, the phrase ``opportunity to review their data
before the information is published'' is corrected to read
``opportunity to preview their data before the information is
published''.
(2) Lines 5 and 6, the phrase ``30-day review and corrections
period (the preview process).'' is corrected to read ``30-day preview
period.''.
(3) Lines 22 through 24, the language ``This preview process would
align with that of the Hospital OQR Program (81 FR 79791).'' is
corrected to read ``This preview period policy would align with that of
the Hospital OQR Program (81 FR 79791).''.
b. Third column, line 32 at the end of the second full paragraph,
ending with the phrase ``will be collected quarterly.'', add the
following paragraph: ``After consideration of the public comments we
received, we are finalizing our policies as proposed related to public
reporting of quality data generally under the REHQR Program and
codifying these policies at Sec. 419.95(f).''.
22. On page 82073, first column, line 2 at the end of the fourth
full paragraph, ending with ``Response: We thank the commenter for
their support.'', add the following paragraph: ``After consideration of
the public comments we received, we are finalizing our policies as
proposed related to public reporting of claims-based measure data under
the REHQR Program.''.
23. On page 82074, first column, line 42 at the end of the first
full paragraph, ending with ``transfer to more appropriate care
settings.'', add the following paragraph: ``After consideration of the
public comments we received, we are finalizing our policies as proposed
related to public reporting of the Median Time from ED Arrival to ED
Departure for Discharged ED Patients measure under the REHQR Program.
Specifically, the following measure strata will be made publicly
available: (1) Overall Rate; (2) Reported Measure; (3) Psychiatric/
Mental Health Patients; and (4) Transfer Patients.''.
24. On page 82081, third column, first full paragraph,
a. Lines 32 through 33, the phrase ``Consolidation Appropriations
Act of 2021'' is corrected to read ``Consolidated Appropriations Act,
2021''.
b. Lines 37 and 38, the phrase ``CY 2024 OPPS/ASC PPS proposed
rule'' is corrected to read ``CY 2024 OPPS/ASC proposed rule''.
25. On page 82082, third column, last paragraph, line 35, the
phrase ``hospitals to include'' is corrected to read ``hospitals
include''.
26. On page 82084, second column, under the heading ``2.
Requirement That Hospitals Affirm the Accuracy and Completeness of
Their Standard Charge Information Displayed in the MRF'', line 29, the
phrase ``the MRF count not be certain'' is corrected to read ``the MRF
cannot be certain''.
27. On page 82085, first column, second full paragraph, lines 34
and 35, the phrase ``42 CFR 457.945), finally, a hospital'' is
corrected to read ``42 CFR 457.945). Finally, a hospital''.
28. On page 82088, third column, first footnoted paragraph
(footnote 779), line 9, the phrase ``identifier779 or employer'' is
corrected to read ``identifier or employer''.
29. On page 82097,
a. Second column, first partial paragraph, line 6, the phrase
``hospitals provide'' is corrected to read ``hospitals to provide''.
b. Third column, first partial paragraph,
(1) Line 9, the phrase ``hospitals provide'' is corrected to read
``hospitals to provide''.
(2) Line 25, the phrase ``critical the allowed amount'' is
corrected to read ``critical the algorithm''.
30. On page 82099, second column, first footnoted paragraph
(footnote 790), add the following link to the end: <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2757483">https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2757483</a>.
31. On page 82113, second column, last partial paragraph, line 14,
the phrase ``a link includen the footer'' is corrected to read ``a link
in the footer''.
32. On page 82118, third column, first footnoted paragraph
(footnote 802), add the following link to the end: <a href="https://up-j-gemgem.ubiquityjournal.website/articles/10.5334/egems.200">https://up-j-gemgem.ubiquityjournal.website/articles/10.5334/egems.200</a>.
33. On page 82120, first column, first full paragraph, line 14, the
phrase ``CMS publicize when'' is corrected to read ``CMS should
publicize when''.
34. On page 82142, third column, first full paragraph, lines 16
through 46, the text ``We found that there were 2,381 THA/TKA ASC
claims in CY 2022 with
[[Page 9012]]
an average of 58 Medicare claims per ASC for 41 ASCs. Thus, we estimate
that approximately 58 THA/TKA procedures will occur in each ASC each
year, and that many patients could complete both the pre-operative and
post-operative questionnaires. However, from our experience with using
this measure in the Comprehensive Joint Replacement model, we are also
aware that not all patients who complete the pre-operative
questionnaire will complete the postoperative questionnaire. For the
voluntary CYs 2025, 2026, and 2027 reporting periods, we assume 609
patients will complete the survey (58 patients x 0.50 x 21 ASCs) for a
total of 74 hours annually (609 respondents x 0.120833 hours) at a cost
of $1,524 (74 hours x $20.71) across all ASCs that perform these
procedures. Beginning with mandatory reporting in the CY 2028 reporting
period/CY 2031 payment determination, we estimate a total of 288 hours
(2,381 patients x 0.120833 hours) at a cost of $5,958 (288 hours x
$20.71) across all ASCs performing these procedures.'' is corrected to
read ``We found that there were 881 ASCs which had an average of 48
THA/TKA paid Medicare FFS claims in CY 2022. Thus, we estimate that
approximately 42,288 THA/TKA procedures will occur in ASCs each year,
and that many patients could complete both the pre-operative and post-
operative questionnaires. However, from our experience with using this
measure in the Comprehensive Joint Replacement model, we are also aware
that not all patients who complete the pre-operative questionnaire will
complete the post-operative questionnaire. For the voluntary CYs 2025
through 2027 reporting periods, we assume 10,584 procedures of which
patients can complete a survey (42,288 procedures x 0.50 survey
completion rate x 50 percent ASC participation rate) for a total of
1,279 hours annually (10,584 possible surveys x 0.120833 hours per
survey) at a cost of $26,486 (1,279 hours x $20.71) each year.
Beginning with mandatory reporting in the CY 2028 reporting period/CY
2031 payment determination, we assume 21,144 procedures of which
patients can complete a survey (42,288 procedures x 0.50 survey
completion rate x 100 percent ASC participation rate) for a total of
2,555 hours annually (21,144 possible surveys x 0.120833 hours per
survey) at a cost of $52,912 (2,555 hours x $20.71).''.
35. On page 82143,
a. First column, first partial paragraph,
(1) Lines 18 and 19, the figures ``4 hours (0.167 hours x 21
ASCs)'' is corrected to read ``74 hours (0.167 hours x 441 ASCs)''.
(2) Lines 19 and 20, the figures ``$182 (4 hours x $52.12)'' is
corrected to read ``$3,831'' (74 hours x $52.12)''.
(3) Line 22, the figure ``7'' is corrected to read ``147''.
b. Second column, first partial paragraph,
(1) Line 1, the figures ``(0.33 hours x 21 ASCs)'' are corrected to
read ``(0.33 hours x 441 ASCs)''.
(2) Line 2, the figures ``$365 (7 hours'' are corrected to read
``$7,662 (147 hours''.
(3) Line 4, the figure ``10'' is corrected to read ``220''.
(4) Line 5, the figure ``21'' is corrected to read ``441''.
(5) Line 6, the phrase ``41 ASCs)] at a cost of $539 (10'' is
corrected to read ``881 ASCs)] at a cost of $11,484 (220''.
(6) Line 9, the figure ``14'' is corrected to read ``294''.
(7) Line 10, the phrase ``41 ASCs) at a cost of $712 (14'' is
corrected to read ``881 ASCs) at a cost of $15,306 (294 hours''.
c. Third column, first partial paragraph, line 4, the text
``increase of 302 hours at a cost of $6,670'' is corrected to read
``increase of 2,849 hours at a cost of $68,218''.
d. The table titled ``Table 158: ``Summary of ASCQ Program
Information Collection Burden Change for the CY 2025 Reporting Period/
CY 2027 Payment Determination'' is corrected to read as follows:
BILLING CODE 4120-01-P
[GRAPHIC] [TIFF OMITTED] TR09FE24.009
[[Page 9013]]
36. On page 82144, the table titled ``Table 159: ``Summary of ASCQR
Program Information Collection Burden Change for the CY 2026 Reporting
Period/CY 2028 Payment Determination'' is corrected to read as follows:
[GRAPHIC] [TIFF OMITTED] TR09FE24.010
37. On page 82145, the table titled ``Table 160: ``Summary of ASCQR
Program Information Collection Burden Change for the CY 2027 Reporting
Period/CY 2029 Payment Determination'' is corrected to read as follows:
[[Page 9014]]
[GRAPHIC] [TIFF OMITTED] TR09FE24.011
38. On page 82146, the table titled ``Table 161: ``Summary of ASCQR
Program Information Collection Burden Change for the CY 2028 Reporting
Period/CY 2030 Payment Determination'' is corrected to read as follows:
[[Page 9015]]
[GRAPHIC] [TIFF OMITTED] TR09FE24.012
39. On page 82147, the table titled ``Table 162: ``Summary of ASCQR
Program Information Collection Burden Change for the CY 2029 Reporting
Period/CY 2031 Payment Determination'' is corrected to read as follows:
[[Page 9016]]
[GRAPHIC] [TIFF OMITTED] TR09FE24.013
40. On page 82148, the table titled ``Table 163: ``Summary of ASCQR
Program Information Collection Burden Change for the CY 2030 Reporting
Period/CY 2032 Payment Determination'' is corrected to read as follows:
[[Page 9017]]
[GRAPHIC] [TIFF OMITTED] TR09FE24.014
41. On page 82156, second column, first full paragraph,
a. Line 10, the figure ``0.0'' is corrected to read ``0.1''.
b. Line 11, the figure ``0.4'' is corrected to read ``0.5''.
42. On page 82157,
a. First column, second partial paragraph, line 8, the figure
``2.8'' is corrected to read with ``3.1''.
b. Third column,
(1) First partial paragraph, line 13, the figure ``9.2'' is
corrected to read ``9.1''.
(2) First full paragraph, line 10, the figure ``10'' is corrected
to read ``9.9''.
43. On page 82158, the table titled ``Table 168: Estimated Impact
of the Final CY 2024 Changes for the Hospital Outpatient Prospective
Payment System'' is corrected to read as follows:
[[Page 9018]]
[GRAPHIC] [TIFF OMITTED] TR09FE24.015
[[Page 9019]]
[GRAPHIC] [TIFF OMITTED] TR09FE24.016
[[Page 9020]]
[GRAPHIC] [TIFF OMITTED] TR09FE24.017
44. On page 82162,
a. Second column, first full paragraph, line 24, the figure
``$778.20'' is corrected to read ``$777.39''.
b. Third column, first partial paragraph, line 2, the figure
``$40,466'' is corrected to read ``$40,424''.
c. Third column, under ``2. Estimated Effects of CY 2024 ASC
Payment System Changes'', first paragraph, line 10, the figure
``0.8881'' is corrected to read ``0.889''.
45. On page 82168, second column, first partial paragraph, line 7,
the phrase ``302 hours at a cost of $6,670'' is corrected to read
``2,849 hours at a cost of $68,218''.
46. On page 82171, third column, in footnote 858 the link <a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2800088">https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2800088</a> is
corrected to read ``<a href="https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2800083">https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2800083</a>''.
Elizabeth J. Gramling,
Executive Secretary to the Department, Department of Health and Human
Services.
[FR Doc. 2024-02631 Filed 2-6-24; 4:15 pm]
BILLING CODE 4120-01-C
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