On November 2, the Centers for Medicare & Medicaid Services (CMS) released the calendar year 2024 Hospital Outpatient Prospective Payment System (HOPPS)/Ambulatory Surgery Center (ASC) Payment System final rule. Following are some of the rule’s key provisions impacting Otolaryngology:
- CMS finalized the decision to extend the use of the hospital market basket for an additional two years due to the COVID-19 public health emergency. Initially a five-year interim period was introduced to allow for adequate and accurate data when adjusting the market basket. This two-year extension will allow for data collection in calendar years 2024 and 2025 before adjustments are made.
- CMS finalized the assignment of of CPT codes 3X016 and 3X017 (Posterior Nasal Nerve Ablation) to APC 5165, recognizing these procedures to bedevice intensive , with a payment rate of $5,647.
- The final rule adjusted the APC list moving 42975 (Drug Induced Sleep Endoscopy Evaluation) from 5151 to 5153. CMS also placed 0652T and 0653T (Transnasal EGD Procedures) into 5302 and 0654T (Transnasal EGD Procedures with catheter) into 5303.
- The final rule elected to maintain the APC assignment of C9751 to 1562 given the lack of utilization to date due to the public health emergency. This placement is based on the available 2019 data.
The AAO-HNS will continue to engage with CMS and other government agencies throughout the year through meetings and rule development cycles to advocate for the field of otolaryngology.
