CMS may stop paying for 258 procedures in ASCs

CMS proposed reversing some of the policy changes ASC executives celebrated last year.

Under the 2022 Hospital Outpatient Prospective Payment System and ASC Payment System proposed rule, released July 19, CMS would reinstate the inpatient-only list and remove 258 of the 266 procedures added to the ASC covered procedures list in January. CMS also proposed a new process for adding procedures to the ASC payable list: soliciting nominations for additions.

CMS received several comments after issuing the 2020 final rule that opposed eliminating the inpatient-only list because of patient safety concerns, according to a statement from the agency. CMS is accepting comments on the 2022 proposed rule through Sept. 17.

"The decision by CMS over the past two years to add and remove hundreds of provisions from both the inpatient-only and ambulatory surgery center payable lists have been jarring. Clinicians deserve a better system for advising them on which settings they can use to provide care for Medicare beneficiaries," said Bill Prentice, CEO of the Ambulatory Surgery Center Association. "We hope that a clear process can be codified to allow clinicians to submit data on procedures that they believe can be safely performed in the ASC and to assure transparent decision-making by the agency in response."

ASC owners and operators applauded CMS's decision to phase out the inpatient-only list from 2020 to 2024, which would eliminate a step in the process to achieve payment for those procedures in surgery centers. If the proposed rule is finalized, it will be tougher to achieve payment for higher-acuity cases in ASCs.


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