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January 2023 Update of the Hospital Outpatient Prospective Payment System (OPPS)

The purpose of this Change Request (CR) is to describe changes to and billing instructions for various payment policies implemented in the January 2023 Outpatient Prospective Payment System (OPPS) update. The January 2023 Integrated Outpatient Code Editor (I/OCE) will reflect the Healthcare Common Procedure Coding System (HCPCS), Ambulatory Payment Classification (APC), HCPCS Modifier, and Revenue Code additions, changes, and deletions identified in this CR. This Recurring Update Notification applies to Chapter 4, section 50.8 (Annual Updates to the OPPS Pricer for Calendar Year (CY) 2007 and Later).

The January 2023 revisions to I/OCE data files, instructions, and specifications are provided in the forthcoming January 2023 I/OCE CR.

Download the Guidance Document

Final

Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: December 08, 2022

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DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.