CMS issues late $7K ASC payment hike for sleep apnea procedure

One week after CMS finalized the 2022 rules and reimbursement rates, the agency has released an update raising the rate for closed-loop hypoglossal nerve stimulation, a sleep apnea procedure, by more than $7,000, according to a Nov. 10 news release on a LinkedIn post by Inspire Medical Systems.

CMS published the final Outpatient Prospective Payment System and ASC Payment System rules Nov. 2, in which payment for the procedure was set at about $17,000. CMS acknowledged that a default device offset of 31 percent was mistakenly used for the first calculation, according to the news release.

CMS updated the addendum files and device offset percentage for CPT code 64582 on Nov. 10, setting the final reimbursement rate at the national average of $24,828.64. The addendum used a final device offset percentage of 88.07 percent.

The updated rate goes into effect Jan. 1.

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