CMS proposes changes to price transparency rules, mental health services

Editor's Note

On July 13, the Centers for Medicare & Medicaid Services (CMS) issued a proposal that would increase Medicare hospital outpatient prospective payment system rates by a net 2.8% in 2024 compared to 2023, including a “proposed 3% market basket update, offset by a 0.2% cut for productivity,” the American Hospital Association (AHA) July 13 reports.

According to AHA, CMS has also proposed “several changes to the hospital price transparency requirements” that would require hospitals to “use one of several standardized formats for the machine-readable files; revise the oversight and enforcement process, including by requiring hospital attestations of compliance; and establish new website requirements intended to ease navigation of hospital price transparency files.”

Other proposed provisions from CMS include:

• improving access to behavioral health services, including implementation of a statutorily required Medicare benefit for Intensive Outpatient Programs and a new payment code for remote group psychotherapy
• delaying in-person visit requirement for remote outpatient mental health services until the end of 2024
• expanding and revising the payment structure for Medicare Partial Hospitalization Program services
• updating the Conditions of Participation for Community Mental Health Centers as directed by the Consolidated Appropriations Act of 2023, including coverage for treatment by mental health counselors and marriage and family therapists.

CMS is seeking comments on “ways it can better align the various hospital and insurer price transparency policies” and will accept them through September 11, AHA concluded. OR Manager will be publishing an article on price transparency as it relates to surgical services in the August 2023 issue.