3 things to know about CMS’ plan to pay more for Exparel in ASCs than hospitals

Through CMS’ proposed changes to the outpatient prospective and ASC payment systems for 2019, the agency could pay more for non-opioid pain management drug Exparel in ASCs than in hospitals, the Utilization Review Accreditation Commission reported.

Advertisement

Here are the key details to know:

1. Under the proposed rule, CMS will unpackage non-opioid pain management drugs from surgical supplies.

2. The push for non-opioid pain medications stems from President Trump’s Commission on Combating Drug Addiction and the Opioid Crisis, which recommends reviewing ratesetting policies that make alternative treatment options cost prohibitive.

3. ASCs could benefit from the increased funding because non-opioid treatments are more expensive than opioids.

More articles on coding, billing and collections:
BPCI Advanced to include bundled payments for 3 outpatient clinical episodes: 5 insights
Maximize your 2018 reimbursements: Know your health plans, know your market, and stay on top of trends
Anthem’s New Hampshire Pathway Network includes 87% of state’s ASCs — Here’s its latest move

Advertisement

Next Up in ASC Coding, Billing & Collections

Advertisement

Comments are closed.