Question:

What is the consumer price index for 2022?

Answer:

As you may know, hospital outpatient claims are paid under a reasonable charge basis, with some provisions making specific rules about the charge. According to these regulations, the reasonable charge must not exceed the lowest actual charge of the customary or current charge for the previous 12-month period ending June 30, correlated with the inflation-indexed update. For 2022, the Consumer Price Index (CPI) update is 5.4%. Understand that the inflation-indexed update is calculated based on the change in the applicable CPI for the 12-month period which ends on June 30 of each year. CMS states that “Manual instructions for determining the reasonable charge payment can be found in Publication 100-04, Medicare Claims Processing Manual, Chapter 23, Section 80 through 80.8. If there is not sufficient charge data for a code, the instructions permit considering charges for other similar services and price lists.”

This question was answered in an edition of our Laboratory Compliance Manager. For more hot topics relating to laboratory services, please visit our store or call us at 1.800.252.1578, ext. 2.

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