CMS’ addition of more than 560 codes to the ASC covered procedure list for 2026 has sparked new engagement from ASC leaders interested in expanding service lines, especially for cardiovascular and spine procedures.
The additions include 289 procedures already paid in hospital outpatient departments and 271 procedures coming off the inpatient-only list. The newly covered services include cardiovascular codes for electrophysiology studies, and ablations and percutaneous coronary intervention, as well as spinal codes such as posterior lumbar interbody fusion.
While service line expansions take significant time and planning, leaders are already thinking ahead about the logistics, investments and operational tools necessary to ramp up or add entirely new services.
Here’s what three ASC leaders have recently said about their service line expansion strategy:
1. Playing the long game: Lindsay Lowder, group vice president of operational innovation and strategy for SCA Health, said that adoption of procedures will depend heavily on geography, physician alignment and facility readiness.
“We’ve been pushing for cardiovascular codes for a while, so those are the most exciting part of this update for us,” she said. “That said, we’re not going to see an immediate impact, because that service line requires significant operational ramp-up and physical plant readiness. It’s not like flipping a switch.”
Ms. Lowder said while SCA Health views the addition of cardiovascular procedures as a long-term opportunity, centers will need time to prepare facilities and build the necessary clinical programs before case volumes shift meaningfully.
“We won’t see CV volume immediately flowing into centers, but it’s a very important shift and one the industry has prioritized for a long time,” she said. “We’re excited to see CMS bring that service line further into the ASC space.”
2. Outpatient expansion as an affordability lever. Dennis Butts, executive vice president and chief strategy and network development officer for Detroit-based Henry Ford Health, said that outpatient cardiology is a key aspect of his system’s affordability and patient access goals.
“I would say that [outpatient cardiology] is something that we’re actively pursuing,” Dennis Butts, executive vice president and chief strategy and network development officer for Detroit-based Henry Ford Health. “It’s a key part of our strategy. It is something that we are proactively moving towards as a part of our affordability initiative, not something that we’re waiting for legislation to cause us or force us to be in that space.”
3. Recognizing where growth is appropriate. Nikhil Shetty, MD, COO of Munster-Ind.-based Midwest Interventional Spine Specialists, said that when it comes to new spine procedures or higher acuity patients, ASCs should always exercise caution and evaluate whether they have the capabilities to expand successfully.
“Everybody looks at the reimbursement of an outpatient spinal fusion and wants to start incorporating that into a service line in their own ASC. What is even more important than that is to know what you’re good at. At the ASC that we run in northwest Indiana, we’ve been doing interventional spine and pain procedures for a little over 10 years. We’ve become very proficient as clinicians and nurse practitioners. Our clinical staff in the ASC, the nursing staff, the operating nurse and our pre-op and post-op areas become very in tune with managing and caring for interventional pain patients and the types of procedures that we do,” he said.
“As we grow our proficiency in that space we try to maximize what we can do while staying within our wheelhouse,” Dr. Shetty continued. “I think sometimes ASC leaders get into trouble when they want to incorporate a new service line for something that their staff is not necessarily capable of handling. We’re very well aware of what we are proficient at, and we like to stay within our wheelhouse specifically with interventional pain and maximizing our outcomes. I want to do the best job I can for my interventional pain patients, and the same mindset is disseminated across my staff in our ASC and our office space.”
