On August 1, 2023, the Centers for Medicare and Medicaid Services (CMS) issued the Hospital Inpatient Prospective Payment System (IPPS) final rule. The final rule updates Medicare reimbursements under IPPS by 3.1% (3.3% IPPS hospital market basket update less a statutorily required 0.2% productivity adjustment).

Why it matters: While radiation therapy reimbursement is typically tied to the Medicare Physician Fee Schedule (MPFS) or the Hospital Outpatient Prospective Payment System (HOPPS), the IPPS final rule includes items of interest to radiation oncology:

• New Technology Add-On Payments (NTAP) for New Services and Technologies for FY 2024
• Continuation of the Low Wage Index Hospital Policy
• Permanent Cap on Wage Index Decreases and Budget Neutrality Adjustment
• Modification to the Rural Wage Index Calculation Methodology
• PPS-Exempt Cancer Hospital Quality Reporting Program (PCHQR)
• Hospital Inpatient Quality Reporting (IQR) Program
• Medicare Promoting Interoperability Program
• Request for Information on Challenges Faced by Safety-Net Hospitals
• Changes to the Severity Level Designation for Z Codes Describing Homelessness

The final rule takes effect on October 1, 2023. Read ASTRO’s summary of the final rule for more information.