California’s lower workers’ comp ASC pay rates 2 years later — 3 key notes

A study produced by the California Workers’ Compensation Information Rating Bureau and California Workers’ Compensation Institute released a report about how compensation reforms have lowered payments to ASCs for workers’ compensation patients, according to a Business Insurance report.

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In 2012, the state passed S.B. 863 to reduce the fee schedule for outpatient surgical services. The payment rate was lowered from 120 percent Medicare rates to 80 percent Medicare rates.

Here are three key points from the study:

1. The average fee per procedure at ASCs dropped 29 percent in 2013 and 2014 to $1,123.

2. The average fee paid to ASCs per episode for workers’ compensation patients dropped 27 percent after the new rates went into effect, averaging just $1,524 per episode.

3. The fee reductions went beyond the estimated 25 percent cost savings.

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