CMS aims to reinstate the inpatient only list, boost ASC pay 2.3% in 2022

CMS issued the 2022 Hospital Outpatient Prospective Payment System and ASC Payment System proposed rule July 19, which includes some big updates for ASCs.

Six takeaways on the proposed rule:

1. ASCs that meet relevant reporting quality requirements would see a 2.3 percent pay increase next year, based on a 2.5 percent projected hospital market basket increase and 0.2 percent reduction for productivity.

2. The proposed conversion factor for ASCs is $49.06, lower than $84.46 for hospital outpatient departments.

3. The proposed rule would halt efforts to eliminate the inpatient-only list and remove 258 codes added to the ASC covered procedure list in January. Click here to read more.

4. CMS' existing policy gives device-intensive status to procedures where the device costs 30 percent of the HOPD rate. Under the proposed rule update, CMS would grant device-intensive status to procedures where the device is 30 percent of the ASC procedure rate as well.

5. The proposed rule would require ASCs to collect data about COVID-19 vaccination coverage among healthcare personnel and reinstate quality data collection measures previously eliminated because ASCs had such high performance rates.

6. CMS proposed voluntary Outpatient Ambulatory Surgery Consumer Assessment of Healthcare Providers and Systems participation in the 2023 calendar year, and then making reporting mandatory in 2024.

CMS will accept comments on its proposed rule through Sept. 17 here.

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