In November, CMS finalized its Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System rule for 2026, which included the addition of 573 codes to the ASC Covered Procedures List. This was a huge win for the Ambulatory…
ASC Coding, Billing & Collections
A McAllen, Texas-based physician and a clinic employee have been sentenced for their roles in a kickback scheme that resulted in more than $3.1 million in Medicare losses, according to a Jan. 13 news release from the U.S. Attorney’s Office.…
As surgical cases continue to shift out of the hospital and into outpatient facilities, physician offices have become increasingly common settings for less-invasive procedures. Here are three recent developments related to the rise in office-based procedures and the regulations surrounding…
In November, CMS finalized its Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System rule for 2026, which included the addition of 573 codes to the ASC Covered Procedures List. The update represented a significant advocacy win for…
Anderson, S.C.-based Clinical Laboratory, formerly known as Labtech Diagnostics, agreed to pay at least $6.8 million to resolve allegations it paid illegal kickbacks to physicians, according to a Jan. 8 news release from the Justice Department. What happened?
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Memphis-based physician Sanjeev Kumar has been convicted for 40 criminal counts on healthcare fraud and improper reuse of medical devices, according to a Jan. 8 news release from the U.S. Attorney’s Office for the Western District of Tennessee. What happened?
From CMS updates to certificate-of-need laws, several policy changes in the last 18 months signal a major shift in how ASCs are taxed, licensed and regulated at both the state and federal levels. Below is a breakdown of the newest…
UnitedHealthcare is updating its reimbursement policy for radiology services billed with evaluation and management services for dates of service on or after April 1. Beginning April 1, when the same provider bills both an E/M service and a global radiology…
Malpractice awards of over $10 million are being doled out more frequently in recent years, the American Medical Association reported Jan. 2. Here are six takeaways from the report: 1. According to an AMA report released in February 2025, there…
As reimbursement pressure intensifies and payers accelerate site-of-service shifts, ASCs are entering 2025 facing a payer landscape that is becoming increasingly unpredictable. Andrew Lovewell, CEO of Columbia Orthopaedic Group, joined Becker’s to discuss how payer dynamics are evolving and where…