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CMS finalizes ASC payment, policy changes: 5 things to know

CMS has finalized the Calendar Year 2016 Hospital Outpatient Prospective Payment System and ASC Payment System changes.

Here are five things to know.

1. Under the CY 2016 OPPS/ASC final rule, ASC payments are annually updated based on a percentage increase in the Consumer Price Index for all urban consumers. Additionally, the Medicare statute applies a multifactor productivity adjustment to the ASC annual update.

2. For CY 2016, the CPI-U update is 0.8 percent, and the MFP adjustment is 0.5 percent. The MFP-adjusted CPI-U update factor is 0.3 percent.

3. CMS is also removing stereotactic radiosurgery treatment services CPT codes from the ASC covered ancillary services list.

4. Under the final rule, Ambulatory Payment Classification groups are being restructured. CMS reorganized and consolidated several APCs across all nine clinical APC families. CMS is finalizing the restructure with modifications in response to public comments.

5. CMS did not propose any new measures for the ASC Quality Reporting Program, but requested comments on two possible future measures: Normothermia Outcome and Unplanned Anterior Vitrectomy. ASCs are subject to a 2 percentage point reduction in their annual payment updates if they do not meet ASCQR Program requirements.

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