The Outpatient Prospective Payment System (OPPS) final rule was published a few days ago and buried in a table was the new rate for G0277, the “facility fee” for hyperbaric oxygen therapy (HBOT). The rate for 2024 is $73.64 for a 30-minute segment from the current $125.07. That’s an unsustainable decrease of 40%. There was no warning about this in the proposed rule that would have allowed some kind of response before the final rule came out.
What does this mean? It means that on January 1, 2024, the facility payment rate for a hyperbaric oxygen treatment will go down by 40%. This will be the end of many HBOT programs.
I have provided an email blast from the Undersea and Hyperbaric Medical Society (UHMS) which explains how hospitals and practitioners can comment on the final rule. While it’s possible that a ground swell of comments from everyone will get the attention of the Centers for Medicare and Medicaid Services (CMS), they are only obligated to correct “errors”. Unfortunately, VERY preliminary information suggests that the source of the problem was not “mistake” on the part of CMS but was caused by erroneous cost data submitted to CMS by hospitals. If that is what happened this time, I can tell you that it’s happened before. In 1998 as I took over the UHMS presidency, the facility payment rate was cut by 75% as a result of incorrect cost data submitted by hospitals. We managed to get this fixed, but it took expensive attorneys and a year out of my life as well as that of the late Robert Warriner, III and several others. At the time, CMS told us that they’d make any necessary corrections the following year – maybe. I suspect that to get this fixed before hyperbaric facilities start to close will require a lot of people to help pay legal fees.
Right now, what we need is for people to follow the instructions outlined by the UHMS to submit a comment, and to use social media to spread the word that hyperbaric oxygen therapy is in a crisis that will most certainly impact access to care.