6 ASC reimbursement updates in the past 100 days

Angie Stewart - Print  |

Since July 1, Becker's ASC Review has reported six significant changes and proposed changes to reimbursement for ASCs:

1. CMS' proposed hospital outpatient payment rule for 2021 would increase ASC reimbursement rates about 2.6 percent, if approved as drafted. 

2. CMS released its Medicare Physician Fee Schedule proposed rule for 2021 on Aug. 3, proposing several drastic cuts to payment rates for both general and specialty surgeons. Cardiovascular surgeons, thoracic surgeons, vascular surgeons, neurosurgeons, and ophthalmologists would see the biggest impacts to their reimbursement rates.

3. Separate payment status for the use of the cataract surgery drug Omidria in ASCs expired Oct. 1, according to an update from Omeros Corp.

4. CMS updated the reimbursement calculation for Wright Medical's Augment regenerative solutions to allow for Medicare beneficiaries to undergo procedures with the product in ASCs and hospital outpatient departments, according to a July 20 announcement.

5. CMS granted Intersect ENT's Sinuva Sinus Implant transitional pass-through payment status for reimbursement under the Hospital Outpatient Prospective Payment System and Ambulatory Surgery Center Payment System. A new C-code for the product took effect July 1.

6. Code C1748 was implemented July 1 for providers using single-use duodenoscopes to treat Medicare patients in ASCs and hospital outpatient departments.

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