December 3, 2024
Calendar Year 2025 Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center (ASC) Payment System Final Rule
The Centers for Medicare & Medicaid Services’ Calendar Year (CY) 2025 Hospital OPPS/ASC Payment System Final Rule (89 FR 93912) was published by the Office of the Federal Register on November 27, 2024.
Program information for outpatient quality reporting begins with cross-program changes for the Hospital Outpatient Quality Reporting Program, Rural Emergency Hospital Quality Reporting Program, and the Ambulatory Surgical Center Quality Reporting Program at Section XIV, pages 94367-94404; https://www.govinfo.gov/content/pkg/FR-2024-11-27/pdf/2024-25521.pdf#page=456.
Individual program information can be found in the following sections of the final rule:
- Hospital Outpatient Quality Reporting (OQR) Program at section XV/pages 94404-94425; https://www.govinfo.gov/content/pkg/FR-2024-11-27/pdf/2024-25521.pdf#page=493;
- Rural Emergency Hospital Quality Reporting (REHQR) Program at section XVI/pages 94425-94430; https://www.govinfo.gov/content/pkg/FR-2024-11-27/pdf/2024-25521.pdf#page=514;
- Ambulatory Surgical Center Quality Reporting (ASCQR) Program at section XVII/pages 94430-94440; https://www.govinfo.gov/content/pkg/FR-2024-11-27/pdf/2024-25521.pdf#page=519; and
- Inpatient Quality Reporting (IQR) Program at section XXII/pages 94495-94499; https://www.govinfo.gov/content/pkg/FR-2024-11-27/pdf/2024-25521.pdf#page=584.
Inpatient facilities participating in the Hospital IQR Program are encouraged to review the hybrid measure changes, which further extend the voluntary reporting period under the Inpatient Prospective Payment System (IPPS) through the Fiscal Year (FY) 2027 payment determination.
Major provisions of the CY 2025 OPPS/ASC Payment System Final Rule are also discussed on the CMS website.