Reimbursement for outpatient cardiology procedures has been a key issue for advocacy groups such as the Ambulatory Surgery Center Association and the American College of Cardiology for years as procedures continue migrating to ASCs.
When CMS finalized its Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System rule for 2026, it included the addition of 573 codes to the ASC Covered Procedures List. This included several cardiovascular codes, including electrophysiology ablation procedures.
The ACC is continuing its push to improve Medicare payments for cardiology services in the 2026 legislative session, the organization said in a Feb. 26 post on its website. It writes that cuts to Medicare have resulted in a $700 million loss for cardiology services over the last five years, which it, along with other stakeholders in the cardiovascular space, urge Congress to adjust with an inflationary update to the Medicare Physician Fee Schedule, according to the post.
The ACC says that it plans to meet with members of the GOP Doctors Caucus to highlight how payment instability impacts clinicians, practice and patient access.
In terms of specific legislation, the ACC notes its support for the Strengthening Medicare for Patients and Providers Act, HR 6169, which would apply annual inflationary updates to the PFS. It specifically pushes back against the -2.5% efficiency adjustment included in the 2026 final rule—a policy that has sparked outcry among physicians across specialties.
Already this year lawmakers have introduced the Efficiency Adjustment Delay Act, HR 7520, which would postpone implementation of the efficiency adjustment until 2030. The bill also requires CMS to provide empirical evidence justifying the reduction and places restrictions on how any future adjustments will be calculated. Congress is also expected to introduce legislation to increase site neutrality, according to the report.
