CMS Releases Medicare 2024 Outpatient PPS Proposed Rule, Includes Impacts to Payment and Transparency

July 20, 2023

The Centers for Medicare and Medicaid Services (CMS) released July 13 its Outpatient Prospective Payment System (OPPS) proposed rule for 2024, which governs Medicare outpatient payment rates for hospitals paid under OPPS and ambulatory surgical centers. WSHA will provide finance staff at member hospitals with a complete analysis of the rule, including estimates of hospital-specific impacts in the next few weeks. The proposed rule includes:

  • A net 2.8 percent pay increase for hospital outpatient facilities in 2024 comprised of a 3 percent market payment update, minus a 0.2 percent cut for productivity.
  • Potential creation of the intensive outpatient program (IOP) benefit and payment to improve access to behavioral healthcare for Medicare enrollees. The proposed rule includes the scope of benefits, physician certification requirements, coding and billing, and payment rates under the IOP benefit.
  • CMS is also proposing changes for 2024 that would modify standard charge display requirements and enforcement provisions under the federal transparency law. Hospitals would be required to use a standard template when displaying the required standard charges in a machine-readable file. To improve accessibility, hospitals would be required to make a .txt file of the machine-readable files available on their website.

CMS will accept comments on the proposed rule through Sept. 11 and will issue the final rule in early November. WSHA plans to comment on the proposed rule and will provide member hospitals with draft comments in advance of the comment due date. Andrew Busz,


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