CMS Releases Final Rule on the Hospital Outpatient Prospective Payment System

December 7, 2023

In early November, CMS released the Hospital Outpatient Prospective Payment System (OPPS) CY 2024 final rule. The proposed rule included a request for comment on unbundling/unpackaging radiopharmaceuticals, but the final rule did not make any changes to the bundling/packaging policy. All diagnostic radiopharmaceuticals without pass-through status will continue to be bundled/packaged in 2024.

In the final rule, the Centers for Medicare and Medicaid Services (CMS) referenced the comments and stated that they will “take them into consideration for future notice and comment rulemaking. We welcome ongoing dialogue and engagement from stakeholders regarding suggestions for potential future payment changes, including on any of the five potential approaches included in the original comment solicitation as well as any other potential solutions.” SNMMI submitted comments in support of unbundling/unpackaging, as did 137 out of 140 of the stakeholders who submitted comments.

On December 5 SNMMI, along with the FIND Act Coalition, met with CMS to discuss possible paths forward for unbundling/unpackaging radiopharmaceuticals in next year's proposed rule. SNMMI will continue working with CMS, but it’s equally important to continue working with Congress to help pass the FIND Act, a legislative solution for unbundling/unpackaging radiopharmaceuticals, in the coming months.