CMS Change in Hyperbaric Oxygen Therapy

URGENT: CALL TO ACTION!

Comments to CMS must be submitted before December 10th

On November 2, 2023, the Centers for Medicare & Medicaid Services (CMS) finalized Medicare payment rates for Hospital Outpatient Prospective Payment System (OPPS) services for calendar year (CY) 2024.

In the final rule, the facility fee (APC rate) for hyperbaric oxygen therapy (G0277) was reduced to $73.64 per 30-minute segment from the current rate of $125.07 per 30-minute segment.

This is an unsustainable 41.5% decrease. CMS provided no warning or rationale regarding this unexpected change from the proposed rate of $134.51 (initially published in July 2023). Had this been published in the proposed rule, stakeholders would have had the opportunity to comment.

This reduced rate will go into effect on January 1, 2024, unless successfully challenged. 

APWCA is urging all members to submit comments directly to CMS before December 10th.

New APWCA President, William H. Tettelbach, MD, FACP, FIDSA, FUHM, MAPWCA, CWSP, has provided a sample letter for reference and welcomes everyone to draw from his message if they like.

In commenting, please refer to file code CMS-1786-FC and submit in one of these ways: 

  • Electronically. You may submit electronic comments on this regulation to https://www.regulations.gov. Once there enter CMS-1786-FC in the search box then follow the “Submit a comment” instructions.
  • By regular mail. You may mail written comments to the following address ONLY: Centers for Medicare & Medicaid Services, Department of Health and Human Services; Attention: CMS-1786-FC, P.O. Box 8010, Baltimore, MD 21244-8010.

Please allow sufficient time for mailed comments to be received before the close of the comment period.

  • By express or overnight mail. You may send written comments to the following address ONLY: Centers for Medicare & Medicaid Services, Department of Health and Human Services, Attention: CMS-1786-FC, Mail Stop C4-26-05, 7500 Security Boulevard, Baltimore, MD 21244-1850. 

Leave a Comment

Your email address will not be published. Required fields are marked *

Add Comment *

Name *

Email *

Website

Jeffrey A. Niezgoda

MD, MAPWCA,FACP, FIDSA, FUHMS, CW

Dr. Jeffrey Niezgoda is a nationally recognized leader in wound care, hyperbaric medicine, limb preservation, and regenerative medicine with more than 30 years of clinical experience. He is the Past President of the American Professional Wound Care Association (APWCA) and the American College of Hyperbaric Medicine.

Dr. Niezgoda has directed advanced wound care and hyperbaric programs, contributed to medical device development and clinical research, and served in leadership roles supporting innovation in wound management technologies and patient care. His expertise includes wound healing, vascular care, hyperbaric medicine, and regenerative clinical services.

Barbara Delmore

PhD, RN, CWCN, MAPWCA

Dr. Barbara Delmore is a board-certified wound care nurse, researcher, educator, and Senior Nurse Scientist at NYU Langone Health. With more than 35 years of nursing experience, she specializes in pressure injury prevention, chronic wound management, and evidence-based wound care practices.

Dr. Delmore has authored numerous publications, served on professional advisory boards, and received national recognition for her contributions to wound care research, education, and clinical innovation.

Jeffrey Lehrman

DPM, FASPS, MAPWCA

Dr. Jeffrey Lehrman is a nationally recognized expert in wound care documentation, coding, compliance, and podiatric medicine. Through Lehrman Consulting, LLC, he provides education and guidance related to healthcare coding, reimbursement, and regulatory compliance.

Dr. Lehrman serves as a staff liaison at the AMA CPT® Editorial Panel meetings and has held leadership positions within APWCA and other professional organizations focused on wound care and podiatric surgery.

Mark Melin

MD, FACS, RPVI, FACCWS

Dr. Mark Melin is a Senior Associate Consultant at the Mayo Clinic specializing in wound care, vascular medicine, and advanced wound healing technologies. His clinical expertise includes vascular assessment, chronic wound management, and emerging technologies in wound care.

Dr. Melin actively contributes to research, education, and advancements in wound healing practices focused on improving patient outcomes and interdisciplinary care.

Kathya Zinszer

DPM, FAPWCA

Dr. Kathya Zinszer is a podiatric physician specializing in diabetic foot care, wound management, limb preservation, and public health advocacy. She currently serves at Geisinger Medical Center and has extensive experience in both clinical practice and wound care education.

Dr. Zinszer has contributed to wound care publications, professional organizations, and clinical guideline initiatives related to diabetic foot management and wound prevention strategies.

Thomas E. Serena

MD, FACS, FACHM, MAPWCA

Dr. Thomas Serena is an internationally recognized wound care specialist, researcher, educator, and founder of The SerenaGroup®. He has established wound care centers throughout the United States and internationally and has led more than 100 clinical trials focused on wound healing and advanced therapies.

Dr. Serena has authored hundreds of scientific publications, delivered lectures worldwide, and held leadership positions within multiple wound care organizations, including APWCA, the Wound Healing Society, and the American College of Hyperbaric Medicine.