Lexology November 27, 2023
The Centers for Medicare & Medicaid Services (CMS) has announced new measures to enhance access to behavioral health services for Medicare beneficiaries and improve hospital price transparency as part of the final rule for the calendar year 2024 Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center. The final rule also includes a 3.1% update in payment rates for hospital outpatient and ASC services and sets forth the remedy for 340B payments to qualifying hospitals.
For behavioral health conditions, Medicare continues to cover inpatient psychiatric admissions, partial hospitalization programs, and outpatient therapy. The final rule addresses the coverage gap for patients that require more than outpatient therapy but less than inpatient-level care. Starting in 2024, Medicare will cover intensive outpatient...
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