CMS Publishes CY 2025 OPPS, ASC, Physician Fee Schedule Final Rules

CMS Publishes CY 2025 OPPS, ASC, Physician Fee Schedule Final Rules

The Centers for Medicare and Medicaid Services (CMS) today published the Calendar Year (CY) 2025 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Final Rule. The rule finalizes an update to OPPS payment rates of 2.9% for hospitals that meet applicable quality reporting requirements. In addition to finalizing payment rates, this year’s rule includes policies aimed to address the maternal health crisis, ameliorate health disparities, expand access to behavioral health care, improve transparency in healthcare, and more. A fact sheet is linked here and the CMS press release here. 

Also today, CMS published the CY 2054 Physician Fee Schedule (PFS) Final Rule.  A fact sheet is linked here and the CMS press release is linked here. Average payment rates under the PFS will be reduced by 2.93% in CY 202. The final rule also includes policies that will strengthen primary care, expand access to preventive services, behavioral health, oral health, and caregiver training, and more.