Medicare reimbursements: 5 notes to know

Physicians and ASCs continue to raise concerns about the adequacy of Medicare reimbursement as operating costs continue to soar. 

Here are four CMS actions and one thought leader’s insights:

1. In May, four members of the House of Representatives who are also physicians introduced a bill that would make the use of inflation rates when calculating physician reimbursement rates each year permanent. 

2. While the ASC industry as a whole has opportunity for growth, Raghu Reddy, chief administrative officer of Cumberland-based SurgCenter of Western Maryland, joined Becker's to discuss what would happen if ASC reimbursement issues were not addressed.  

3. The conversion factor used to calculate physician reimbursement declined by $1.55 to $33.06 in 2023, representing a 4.48 percent decrease.

4. In November, CMS released the Medicare payment and policy change final rule. The rule kept a 2 percent Medicare reimbursement cut to physicians in 2023, and 2024 may bring at least another 1.25 percent cut.

5. In its 2023 final rule, CMS considered 64 recommendations for new procedures to be added to the ASC-covered procedures list, but only four procedures that are typically performed in an outpatient setting were chosen. 

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