ASCs will continue to receive separate Medicare reimbursement for certain non-opioid pain management devices in 2026 under the NOPAIN Act.
As part of the ruling, CMS confirmed the Game Ready Pro 2.1 cryo-pneumatic compression system was approved for separate payment, effective Jan. 1. Two other Avanos Medical devices, the ON-Q elastomeric infusion pump and ambIT electronic infusion pump, will retain their separate payment status, which began in 2025, according to a Feb. 3 news release from Avanos.
Each device has a unique healthcare common procedure coding system code for use in ASC and outpatient hospital settings. Medicare payment caps for 2026 are $2,008.72 for the ON-Q and ambIT pumps and $1,997.16 for the Game Ready system when used with covered surgical procedures and deemed medically necessary.
The NOPAIN Act, enacted in 2023, requires CMS to reimburse qualifying non-opioid pain management products separately through 2027 — an effort to reduce postoperative opioid use in ASCs and hospital outpatient departments, according to the release.
At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.