Finding Medicare Fee-For-Service (FFS) 
September 8, 2022 
Payment System Rules: Schedules and 
Michele L. Malloy 
Resources 
Research Librarian 
  
The Medicare Fee-For-Service (FFS) program pays physicians, hospitals, and other health care 
facilities based on statutorily established payment systems, most of which are updated annually 
 
through regulations. These proposed and final rules follow schedules based on requirements 
found in statute, regulation, or both.  
As Medicare FFS payment system proposed and final rules are issued, they impact payments received by health care facilities 
and providers. Congressional Members and committees may comment, and are often contacted by provider and beneficiary 
groups. Tracking the status and requirements for specific rules can be onerous, since they have different schedules and web 
locations. 
This report contains information on these payment system rules in a quick reference table. Specifically, the table compiles the 
payment systems, their main portals on the Centers for Medicare & Medicaid Services (CMS) website, the typical 
rulemaking schedule, statutory and regulatory requirements, and the most recently issued proposed rules, public comments, 
final rules, and subsequent corrections. The table also includes embedded links to the applicable resources. Not all payment 
systems include detailed statutory and regulatory requirements, as noted in the table. 
Congressional Research Service 
 
 link to page 4  link to page 4  link to page 5  link to page 5  link to page 18 Finding Medicare Fee-For-Service (FFS) Payment System Rules 
 
Contents 
Introduction ..................................................................................................................................... 1 
Medicare Fee-For-Service Payment System Rules: Schedules and Resources ............................... 1 
 
Tables 
Table 1. Medicare Fee-For-Service (FFS) Payment System Rules: Schedules and 
Resources ..................................................................................................................................... 2 
  
Contacts 
Author Information ........................................................................................................................ 15 
 
 
Congressional Research Service 
 link to page 5 Finding Medicare Fee-For-Service (FFS) Payment System Rules 
 
Introduction 
The Medicare Fee-For-Service (FFS) program pays physicians, hospitals, and other health care 
facilities based on statutorily established payment systems, most of which are updated annually 
through regulations. These proposed and final rules follow schedules based on requirements 
found in statute, regulation, or both. Medicare payment systems that follow annual regulatory 
updates with comment periods include the following:  
  Medicare Physician Fee Schedule Payment (MPFS or PFS),  
  Hospital Outpatient Prospective Payment System (OPPS),  
  Ambulatory Surgical Center Payment System (ASC Payment System),  
  Acute Inpatient Prospective Payment System (IPPS),  
  Long-Term Care Hospital Prospective Payment System (LTCH PPS),  
  Skilled Nursing Facility Prospective Payment System (SNF PPS),  
  Inpatient Rehabilitation Facility Prospective Payment System (IRF PPS),  
  Inpatient Psychiatric Facility Prospective Payment System (IPF PPS),  
  Home Health Prospective Payment System (Home Health PPS),  
  End Stage Renal Disease Prospective Payment System (ESRD PPS), and  
  Hospice Wage Index and Payment Rate. 
As Medicare FFS payment system proposed and final rules are issued, they impact payments 
received by health care facilities and providers. Congressional Members and committees may 
comment, and are often contacted by provider and beneficiary groups. Tracking the status and 
requirements for specific rules can be onerous, because they have different schedules and web 
locations. This report contains information on these payment system rules in a quick reference 
table.  
To learn more about these payment systems, please see applicable sections of CRS Report 
R40425, Medicare Primer. In addition, the Medicare Payment Advisory Commission (MedPAC) 
produces Payment Basics,1 a series of brief overviews of how Medicare’s payment systems 
function. 
Medicare Fee-For-Service Payment System Rules: 
Schedules and Resources 
Medicare FFS payment system rules and the associated statutory and regulatory requirements 
regarding timeline and public comment can be difficult to locate. Table 1 compiles the payment 
systems; their main portals on the Centers for Medicare & Medicaid Services (CMS) website; the 
typical rulemaking schedule; statutory and regulatory requirements; and the most recently issued 
proposed and final rules, including agency docket numbers, Federal Register citations, public 
comments available on Regulations.gov, and any corrections issued. The table also includes 
embedded links to the applicable resources and notes when rulemaking timelines and comment 
periods are not specified. Not all payment systems include detailed statutory and regulatory 
requirements, as noted in the table. 
                                                 
1 MedPAC, Payment Basics, at http://medpac.gov/-documents-/payment-basics.  
Congressional Research Service  
 
1 
 link to page 17  
Table 1. Medicare Fee-For-Service (FFS) Payment System Rules: Schedules and Resources 
 
Typically Issued 
Requirements: Timeline and Public Comment 
 
Rule Name and 
Proposed 
Most Recently 
Payment System(s)a 
Rule 
Final Rule 
Statutory  
Regulatory  
Issued Rule(s) 
Payment Policies Under the  July-August  November 
42 USC §1395w-4: Payment for 
N/A 
2023 Proposed Rule 
Physician Fee Schedule 
physicians’ services 
(7/29/2022) CMS-1770-P 
 
(b)(1) “Before November 1 of 
87 FR 45860 
Medicare Physician Fee 
the preceding year, for each year 
Comments: Regulations.gov 
Schedule Payment (PFS)  
beginning with 1998, subject to 
subsection (p), the Secretary 
CMS-2022-0113 
shall establish, by regulation, fee 
 
schedules that establish payment 
2022 Final Rule 
amounts for all physicians' 
services furnished in all fee 
(11/19/2021) CMS-1751-F 
schedule areas (as defined in 
86 FR 64996 
subsection (j)(2)) for the year." 
 
 
2022 Proposed Rule 
Note: Public comment is not 
(7/23/2021) CMS-1751-P 
addressed broadly for PFS in 
statute. However, public 
86 FR 39104 
comment is addressed for 
Comments: Regulations.gov 
aspects of the physician payment 
CMS-2021-0119 
system, such as the development 
 
of categories and codes. 
2021 Final Rule  
(12/28/2020) CMS-1734-F 
85 FR 84472 
Corrections: 86 FR 5020 
(1/19/2021) and 86 FR 14690 
(3/18/2021) 
 
2021 Proposed Rule  
(8/17/2020) CMS-1734-P 
85 FR 50074  
CRS-2 
 link to page 17  
 
Typically Issued 
Requirements: Timeline and Public Comment 
 
Rule Name and 
Proposed 
Most Recently 
Payment System(s)a 
Rule 
Final Rule 
Statutory  
Regulatory  
Issued Rule(s) 
Comments: Regulations.gov 
CMS-2020-0088 
 
2020 Final Rule  
(11/15/2019) CMS-1715-F 
84 FR 62568 
  
2020 Proposed Rule  
(8/14/2019) CMS-1715-P 
84 FR 40482 
Comments: Regulations.gov 
CMS-2019-0111 
Hospital Outpatient 
July-August  November
42 USC §1395l: Payment of 
42 CFR §419.50 Annual review. 
2023 Proposed Rule 
Prospective Payment and 
-December  benefits 
  
(7/26/2022) CMS-1772-P 
Ambulatory Surgical 
(t) Prospective payment system 
Center Payment Systems 
42 CFR §416.130 Publication of revised 
87 FR 44502 
for hospital outpatient 
payment methodologies. 
  
department services 
Comments: Regulations.gov 
"Whenever CMS proposes to revise the 
Hospital Outpatient 
  
CMS-2022-0118 
payment rate for ASCs, CMS publishes a notice 
Prospective Payment 
Note: Specific timelines for 
in the Federal Register describing the revision. 
 
System (OPPS) 
rulemaking and comments are 
The notice also explains the basis on which the 
2022 Final Rule 
 
not addressed in statute. 
rates were established. After reviewing public 
(11/16/2021) CMS-1753-FC 
Ambulatory Surgical 
  
comments, CMS publishes a notice establishing 
86 FR 63458 
Center (ASC) Payment 
the rates authorized by this section. In setting 
42 USC §1395l: Payment of 
 
System 
these rates, CMS may adopt reasonable 
benefits 
classifications of facilities and may establish 
2022 Proposed Rule 
(i) Outpatient surgery 
different rates for different types of surgical 
(8/4/2021) CMS-1753-P 
“Taking into account the 
procedures." 
86 FR 42018 
recommendations in the report 
under section 626(d) of 
Comments: Regulations.gov 
Medicare Prescription Drug, 
CMS-2021-0124 
Improvement, and Modernization 
 
Act of 2003, the Secretary shall 
CRS-3 
 link to page 17  
 
Typically Issued 
Requirements: Timeline and Public Comment 
 
Rule Name and 
Proposed 
Most Recently 
Payment System(s)a 
Rule 
Final Rule 
Statutory  
Regulatory  
Issued Rule(s) 
implement a revised payment 
2021 Final Rule 
system for payment of surgical 
(12/29/2020) CMS-1736-FC  
services furnished in ambulatory 
surgical centers." 
85 FR 85866 
  
Corrections: 86 FR 11428 
(2/25/2021) 
Note: Specific timelines for 
rulemaking and comments 
  
beyond the initial year are not 
2021 Proposed Rule 
addressed in statute. 
(8/12/2020) CMS-1736-P  
85 FR 48772 
Comments: Regulations.gov 
CMS-2020-0090 
  
2020 Final Rule 
(11/27/2019) CMS-1717-F2  
84 FR 65524 
  
2020 Proposed Rule 
(8/9/2019) CMS-1717-P 
84 FR 39398 
Comments: Regulations.gov 
CMS-2019-0109 
Hospital Inpatient 
April-May 
August-
42 USC §1395ww: Payments to 
42 CFR §412.8 Publication of schedules for 
2023 Final Rule 
Prospective Payment 
October 
hospitals for inpatient hospital 
determining prospective payment rates. 
(8/10/2022) CMS-1771-F 
Systems for Acute Care 
services 
"(b) Annual publication of schedule for 
Hospitals and the Long-
87 FR 48780 
(e)(1)(C)(5) 
determining prospective payment rates. (1) 
Term Care Hospital 
CMS proposes changes in the methods, 
 
Prospective Payment 
“The Secretary shall cause to 
amounts, and factors used to determine 
2023 Proposed Rule 
System  
have published in the Federal 
Register, not later than- (A) the 
inpatient prospective payment rates in a 
(5/10/2022) CMS-1771-P 
  
April 1 before each fiscal year 
Federal Register document published for public 
87 FR 28108 
(beginning with fiscal year 1986), 
comment not later than the April 1 before the 
CRS-4 
 link to page 17  
 
Typically Issued 
Requirements: Timeline and Public Comment 
 
Rule Name and 
Proposed 
Most Recently 
Payment System(s)a 
Rule 
Final Rule 
Statutory  
Regulatory  
Issued Rule(s) 
Acute Inpatient 
the Secretary’s proposed 
beginning of the Federal fiscal year in which the 
Comments: Regulations.gov 
Prospective Payment 
recommendations under 
proposed changes would apply. 
CMS-2022-0074 
System (IPPS)  
paragraph (4) for that fiscal year 
(2) Except as provided in paragraph (c) of this 
 
  
for public comment, and (B) the 
section, CMS publishes a Federal Register 
August 1 before such fiscal year 
2022 Final Rule  
Long-Term Care Hospital 
document setting forth final methods, amounts, 
after such consideration of public 
(8/13/2021) CMS-1752-F 
Prospective Payment 
and factors for determining inpatient 
comment on the proposal as is 
System (LTCH PPS) 
prospective payment rates not later than the 
86 FR 44774 
feasible in the time available, the 
August 1 before the Federal fiscal year in which 
 
Secretary's final 
the rates would apply." 
recommendations under such 
2022 Proposed Rule  
paragraph for that year." 
  
(5/10/2021) CMS-1752-P 
  
42 CFR §412.535 Publication of the Federal 
86 FR 25070 
prospective payment rates. 
42 USC §1395ww: Payments to 
Corrections: 86 FR 33157 
hospitals for inpatient hospital 
"Except as specified in paragraph (b), CMS 
(6/24/2021) 
services 
publishes information pertaining to the long-
term care hospital prospective payment system 
Comments: Regulations.gov 
(m) Prospective payment for 
effective for each annual update in the Federal 
CMS-2021-0070 
long-term care hospitals 
Register. 
  
  
(c) For the period beginning on or after 
2021 Final Rule  
Note: Specific timelines for 
October 1, 2009, information on the 
(9/18/2020) CMS-1735-F  
rulemaking and comments for 
unadjusted Federal payment rates and a 
Long-Term Care Hospital PPS 
description of the methodology and data used 
85 FR 58432 
are not addressed in statute. 
to calculate the payment rates are published on 
Corrections: 85 FR 78748 
or before August 1 prior to the start of the 
(12/7/2020) 
Federal fiscal year which begins October 1, 
  
unless for good cause it is published after 
2021 Proposed Rule  
August 1, but before September 1. 
(5/29/2020) CMS-1735-P 
(d) Information on the LTC-DRG classification 
and associated weighting factors is published on  85 FR 32460 
or before August 1 prior to the beginning of 
Comments: Regulations.gov 
each Federal fiscal year." 
CMS-2020-0052 
  
2020 Final Rule  
(8/16/2019) CMS-1716-F 
CRS-5 
 link to page 17  
 
Typically Issued 
Requirements: Timeline and Public Comment 
 
Rule Name and 
Proposed 
Most Recently 
Payment System(s)a 
Rule 
Final Rule 
Statutory  
Regulatory  
Issued Rule(s) 
84 FR 42044 
  
2020 Proposed Rule  
(5/3/2019) CMS-1716-P 
84 FR 19158 
Corrections: 84 FR 28263 
(6/18/2019) 
Comments: Regulations.gov 
CMS-2019-0073 
Prospective Payment 
April-May 
August 
42 USC §1395yy: Payment to 
42 CFR §413.345 Publication of Federal 
2023 Final Rule 
System and Consolidated 
skilled nursing facilities for 
prospective payment rates. 
(8/3/2022) CMS-1765-F 
Billing for Skilled Nursing 
routine service costs 
"CMS publishes information pertaining to each 
Facilities (SNF) 
87 FR 47502 
(e)(4)(H) 
update of the Federal payment rates in the 
  
 
“The Secretary shall provide for 
Federal Register. This information includes the 
Skilled Nursing Facility 
publication in the Federal 
standardized Federal rates, the resident 
2023 Proposed Rule  
Prospective Payment 
Register, before May 1, 1998 
classification system that provides the basis for 
(4/15/2022) CMS-1765-P 
System (SNF PPS) 
(with respect to fiscal period 
case-mix adjustment, and the factors to be 
87 FR 22720 
described in subparagraph (E)(i)) 
applied in making the area wage adjustment. 
Comments: Regulations.gov 
and before the August 1 
This information is published before May 1 for 
preceding each succeeding fiscal 
the fiscal year 1998 and before August 1 for the  CMS-2022-0069 
year (with respect to that 
fiscal years 1999 and after." 
 
succeeding fiscal year), of- 
2022 Final Rule 
(i) the unadjusted Federal per 
(8/4/2021) CMS-1746-F 
diem rates to be applied to days 
of covered skilled nursing facility 
86 FR 42424 
services furnished during the 
 
fiscal year, 
2022 Proposed Rule  
(ii) the case mix classification 
(4/15/2021) CMS- 1746-P 
system to be applied under 
86 FR 19954 
subparagraph (G)(i) with respect 
to such services during the fiscal 
Comments: Regulations.gov 
year, and 
CMS-2021-0062 
CRS-6 
 link to page 17  
 
Typically Issued 
Requirements: Timeline and Public Comment 
 
Rule Name and 
Proposed 
Most Recently 
Payment System(s)a 
Rule 
Final Rule 
Statutory  
Regulatory  
Issued Rule(s) 
(iii) the factors to be applied in 
  
making the area wage adjustment 
2021 Final Rule  
under subparagraph (G)(ii) with 
respect to such services." 
(8/5/2020) CMS-1737-F  
  
85 FR 47594 
Note: The timeline for the 
  
proposed rule and comments are 
2021 Proposed Rule  
not addressed in statute. 
(4/15/2020) CMS-1737-P 
85 FR 20914 
Comments: Regulations.gov 
CMS-2020-0036  
  
2020 Final Rule  
(8/7/2019) CMS-1718-F  
84 FR 38728 
  
2020 Proposed Rule  
(4/25/2019) CMS-1718-P  
84 FR 17620 
Comments: Regulations.gov 
CMS-2019-0070 
Inpatient Rehabilitation 
April-May 
August 
42 USC §1395ww: Payments to 
42 CFR §412.628 Publication of the Federal 
2023 Final Rule 
Facility Prospective 
hospitals for inpatient hospital 
prospective payment rates. 
(8/1/2022) CMS-1767-F 
Payment System 
services 
"We publish information pertaining to the 
87 FR 47038 
  
(j)(5) 
inpatient rehabilitation facility prospective 
 
Inpatient Rehabilitation 
“The Secretary shall provide for 
payment system effective for each fiscal year in 
Facility Prospective 
publication in the Federal 
the Federal Register. This information includes 
2023 Proposed Rule 
Payment System (IRF PPS) 
Register, on or before August 1 
the unadjusted Federal payment rates, the 
(4/6/2022) CMS-1767-P 
before each fiscal year (beginning 
patient classification system and associated 
87 FR 20218 
with fiscal year 2001), of the 
weighting factors, and a description of the 
Comments: Regulations.gov 
classification and weighting 
methodology and data used to calculate the 
CRS-7 
 link to page 17  
 
Typically Issued 
Requirements: Timeline and Public Comment 
 
Rule Name and 
Proposed 
Most Recently 
Payment System(s)a 
Rule 
Final Rule 
Statutory  
Regulatory  
Issued Rule(s) 
factors for case mix groups 
payment rates. This information is published on 
CMS-2022-0061 
under paragraph (2) for such 
or before August 1 prior to the beginning of 
 
fiscal year and a description of 
each fiscal year." 
the methodology and data used 
2022 Final Rule 
in computing the prospective 
(8/4/2021) CMS-1748-F 
payment rates under this 
86 FR 42362 
subsection for that fiscal year." 
 
  
2022 Proposed Rule  
Note: Only the final rule 
(4/12/2021) CMS-1748-P 
deadline is specified, the 
proposed rule is not addressed 
86 FR 19086 
in statute. Public comment is not 
Comments: Regulations.gov  
addressed in statute. 
CMS-2021-0057 
  
2021 Final Rule  
(8/10/2020) CMS-1729-F  
85 FR 48424 
  
2021 Proposed Rule  
(4/21/2020) CMS-1729-P 
85 FR 22065 
Comments: Regulations.gov 
CMS-2020-0039 
  
2020 Final Rule  
(8/8/2019) CMS-1710-F 
84 FR 39054 
  
2020 Proposed Rule  
(4/24/2019) CMS-1710-P 
CRS-8 
 link to page 17  
 
Typically Issued 
Requirements: Timeline and Public Comment 
 
Rule Name and 
Proposed 
Most Recently 
Payment System(s)a 
Rule 
Final Rule 
Statutory  
Regulatory  
Issued Rule(s) 
84 FR 17244 
Corrections: 84 FR 24734 
(5/29/2019) 
Comments: Regulations.gov 
CMS-2019-0066 
Inpatient Psychiatric 
April-May 
August 
42 USC §1395ww: Payments to 
42 CFR §412.428 Publication of changes to the 
2023 Final Rule 
Facilities Prospective 
hospitals for inpatient hospital 
inpatient psychiatric facility prospective 
(7/29/2022) CMS-1769-F 
Payment System 
services 
payment system. 
87 FR 46846 
  
(s) Prospective payment for 
“CMS will issue annually in the Federal Register 
 
Inpatient Psychiatric Facility 
psychiatric hospitals 
information pertaining to changes to the 
Prospective Payment 
  
inpatient psychiatric facility prospective 
2023 Proposed Rule 
System (IPF PPS) 
payment system." 
Note: specific timelines for 
(4/4/2022) CMS-1769-P 
rulemaking and comments for 
87 FR 19415 
Inpatient Psychiatric Facility PPS 
Comments: Regulations.gov 
are not addressed in statute. 
CMS-2022-0062 
Deadlines for quality measures 
are specified. 
 
2022 Final Rule 
(8/4/2021) CMS-1750-F 
86 FR 42608 
 
2022 Proposed Rule  
(4/13/2021) CMS-1750-P 
86 FR 19480 
Comments: Regulations.gov  
CMS-2021-0060 
  
2021 Final Rule  
(8/4/2020) CMS-1731-F  
85 FR 47042 
CRS-9 
 link to page 17  link to page 17  
 
Typically Issued 
Requirements: Timeline and Public Comment 
 
Rule Name and 
Proposed 
Most Recently 
Payment System(s)a 
Rule 
Final Rule 
Statutory  
Regulatory  
Issued Rule(s) 
Corrections: 85 FR 52923 
(8/27/2020) 
  
2021 Proposed Rule 
(4/14/2020) CMS-1731-P 
85 FR 20625 
Comments: Regulations.gov 
CMS-2020-0035 
  
2020 Final Rule  
(8/6/2019) CMS-1712-F 
84 FR 38424 
  
2020 Proposed Rule  
(4/23/2019) CMS-1712-P 
84 FR 16948 
Comments: Regulations.gov 
CMS-2019-0067 
Home Health Prospective 
July 
November 
42 USC §1395fff: Prospective 
42 CFR §484.225 Annual update of the 
2023 Proposed Rule 
Payment System  
payment for home health 
unadjusted national, standardized prospective 
(6/23/2022) CMS-1766-P 
  
services 
payment rates. 
87 FR 37600 
Home Health Prospective 
  
“CMS annually updates the unadjusted national, 
Comments: Regulations.gov 
Payment System (Home 
Note: Specific timelines for 
standardized prospective payment rate on a 
Health PPS) 
rulemaking and comments for 
calendar year basis (in accordance with section 
CMS-2022-0109 
Home Health PPS are not 
1895(b)(1)(B) of the Act)."b 
 
addressed in statute.  
2022 Final Rule 
(11/9/2021) CMS-1747-F 
86 FR 62240 
 
CRS-10 
 link to page 17  
 
Typically Issued 
Requirements: Timeline and Public Comment 
 
Rule Name and 
Proposed 
Most Recently 
Payment System(s)a 
Rule 
Final Rule 
Statutory  
Regulatory  
Issued Rule(s) 
2022 Proposed Rule  
(7/7/2021) CMS-1747-P 
86 FR 35874 
Comments: Regulations.gov 
CMS-2021-0112 
 
2021 Final Rule  
(11/4/2020) CMS-1730-F  
85 FR 70298 
  
2021 Proposed Rule  
(6/30/2020) CMS-1730-P 
85 FR 39408 
Corrections: 85 FR 43805 
(7/20/2020) 
Comments: Regulations.gov 
CMS-2020-0077 
  
2020 Final Rule  
(11/8/2019) CMS-1711-FC 
84 FR 60478 
  
2020 Proposed Rule  
(7/18/2019) CMS-1711-P 
84 FR 34598 
Comments: Regulations.gov 
CMS-2019-0100 
CRS-11 
 link to page 17  
 
Typically Issued 
Requirements: Timeline and Public Comment 
 
Rule Name and 
Proposed 
Most Recently 
Payment System(s)a 
Rule 
Final Rule 
Statutory  
Regulatory  
Issued Rule(s) 
End-Stage Renal Disease 
July 
November 
42 USC §1395rr: End stage renal 
42 CFR §413.196 Notification of changes in 
2023 Proposed Rule 
Prospective Payment 
disease program 
rate-setting methodologies and payment rates. 
(6/28/2022) CMS-1768-P 
System 
  
“(b) Changes in payment rates resulting from 
87 FR 38464 
  
Note: Specific timelines for 
incorporation of updated cost data or general 
Comments: Regulations.gov 
End Stage Renal Disease 
rulemaking and comments for 
revisions of geographic labor cost adjustment 
Prospective Payment 
ESRD PPS are not addressed in 
factors are announced by notice published in 
CMS-2022-0110 
System (ESRD PPS) 
statute.  
the Federal Register without opportunity for 
 
prior comment. Revisions of the rate-setting 
2022 Final Rule 
methodology are published in the Federal 
Register in accordance with the Department’s 
(11/8/2021) CMS-1749-F 
established rulemaking procedures." 
86 FR 61874 
Corrections: 86 FR 70982 
(12/14/2021) 
 
2022 Proposed Rule  
(7/9/2021) CMS-1749-P 
86 FR 36322 
Comments: Regulations.gov 
CMS-2021-0114 
 
2021 Final Rule 
(11/9/2020) CMS-1732-F  
85 FR 71398 
  
2021 Proposed Rule 
(7/13/2020) CMS-1732-P  
85 FR 42132 
Comments: Regulations.gov 
CMS-2020-0079 
  
CRS-12 
 link to page 17  link to page 17  
 
Typically Issued 
Requirements: Timeline and Public Comment 
 
Rule Name and 
Proposed 
Most Recently 
Payment System(s)a 
Rule 
Final Rule 
Statutory  
Regulatory  
Issued Rule(s) 
2020 Final Rule 
(11/8/2019) CMS-1713-F 
84 FR 60648 
  
2020 Proposed Rule 
(8/6/2019) CMS-1713-P 
84 FR 38330 
Comments: Regulations.gov 
CMS-2019-0110 
Hospice Wage Index and 
April-May 
August 
42 USC §1395f: Conditions of 
42 CFR §418.306 Annual update of the 
2023 Final Rule 
Payment Rate 
and limitations on payment for 
payment rates and adjustment for area wage 
(7/29/2022) CMS-1773-F 
  
services 
differences. 
87 FR 45669 
Hospice Wage Index and 
(i) Payment for hospice care 
“(b) Annual update of the payment rates. The 
 
Payment Rate 
  
payment rates for routine home care and other 
services included in hospice care are the 
2023 Proposed Rule 
Note: Specific timelines for 
payment rates in effect under this paragraph 
rulemaking and comments for 
(4/4/2022) CMS-1773-P 
during the previous fiscal year increased by the 
hospice payment rates are not 
87 FR 19442 
hospice payment update percentage increase 
addressed in statute.  
(as defined in sections1814(i)(1)(C) of the Act), 
Comments: Regulations.gov 
applicable to discharges occurring in the fiscal 
CMS-2022-0060 
year."b 
 
2022 Final Rule 
(8/4/2021) CMS-1754-F 
86 FR 42528 
 
2022 Proposed Rule  
(4/14/2021) CMS-1754-P 
86 FR 19700 
Comments: Regulations.gov  
CMS-2021-0061 
CRS-13 
 link to page 17  
 
Typically Issued 
Requirements: Timeline and Public Comment 
 
Rule Name and 
Proposed 
Most Recently 
Payment System(s)a 
Rule 
Final Rule 
Statutory  
Regulatory  
Issued Rule(s) 
  
2021 Final Rule 
(8/4/2020) CMS-1733-F  
85 FR 47070 
  
2021 Proposed Rule  
(4/15/2020) CMS-1733-P 
85 FR 20949 
Comments: Regulations.gov 
CMS-2020-0037 
  
2020 Final Rule 
(8/6/2019) CMS-1714-F 
84 FR 38484 
 
2020 Proposed Rule  
(4/25/2019) CMS-1714-P 
84 FR 17570 
Comments: Regulations.gov 
CMS-2019-0068 
Source: Compiled by the Congressional Research Service (CRS). 
Notes: Table compiled using Centers for Medicare & Medicaid Services (CMS) websites, Federal Register, and Regulations.gov. In some cases, although multiple payment 
systems are covered by one rule, they are combined here in one row but listed separately. Typical months when proposed and final rules are issued can vary, and the 
months we list are based on CRS analysis of Federal Register publication dates from the past 10 years. Additionally, corrections are sometimes issued after the final rule. 
a.  Some Medicare FFS payment systems are not updated through notice and comment or on an annual basis, but only periodically. These include Clinical Laboratory 
Fee Schedule, Shared Savings Program, and Ambulance Fee Schedule. Please see the embedded CMS links for more information, including the most recent rules.  
b.  At times, regulations reference the Social Security Act rather than the U.S. Code citation. The Social Security Administration provides a cross-reference table at 
https://www.ssa.gov/OP_Home/comp2/G-APP-H.html.  
CRS-14 
Finding Medicare Fee-For-Service (FFS) Payment System Rules 
 
 
 
Author Information 
 
Michele L. Malloy 
   
Research Librarian 
    
 
Acknowledgments 
CRS Analysts Jim Hahn, Marco Villagrana, and Phoenix Voorhies aided in the compilation and review of 
the statutory and regulatory requirements of selected payment system rules. 
 
Disclaimer 
This document was prepared by the Congressional Research Service (CRS). CRS serves as nonpartisan 
shared staff to congressional committees and Members of Congress. It operates solely at the behest of and 
under the direction of Congress. Information in a CRS Report should not be relied upon for purposes other 
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Congressional Research Service  
R46797 · VERSION 8 · UPDATED 
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