CMS has released the 2013 proposed payment rule for ambulatory surgery centers and hospital outpatient departments.
ASCA made the following observations about the new payment rule:
• Inequitable payment continues for surgery centers. ASCA is disappointed that CMS chose to continue the use of the Consumer Price Index for All Urban Consumers (CPI-U) to update ASC rates. ASCA feels CPI-U is an inappropriate system for adjustment of ASC rates and has asked CMS to transition to the same system that is used to update HOPD rates. Under the proposal, the rates paid to ASCs and HOPDs will continue the "troubling trend" of diverging in 2013, the organization said.
The chart below illustrates that the gap between ASC and HOPD reimbursement rates continues to grow:
• No additional quality measures have been proposed. CMS indicated it is not proposing to require any additional quality measures beyond the previously established eight measures, due to the time and effort required from ASCs to prepare for quality reporting.
• 16 new procedures were proposed for the list of ASC payables. CMS has proposed to add 16 procedures to the ASC list of payable procedures beginning Jan. 1, 2013. In addition, five new mid-year codes (0302T, 0303T, 0304T, 0307T and 0308T) will be added effective July 1, 2012.
ASCA made the following observations about the new payment rule:
• Inequitable payment continues for surgery centers. ASCA is disappointed that CMS chose to continue the use of the Consumer Price Index for All Urban Consumers (CPI-U) to update ASC rates. ASCA feels CPI-U is an inappropriate system for adjustment of ASC rates and has asked CMS to transition to the same system that is used to update HOPD rates. Under the proposal, the rates paid to ASCs and HOPDs will continue the "troubling trend" of diverging in 2013, the organization said.
The chart below illustrates that the gap between ASC and HOPD reimbursement rates continues to grow:
• No additional quality measures have been proposed. CMS indicated it is not proposing to require any additional quality measures beyond the previously established eight measures, due to the time and effort required from ASCs to prepare for quality reporting.
• 16 new procedures were proposed for the list of ASC payables. CMS has proposed to add 16 procedures to the ASC list of payable procedures beginning Jan. 1, 2013. In addition, five new mid-year codes (0302T, 0303T, 0304T, 0307T and 0308T) will be added effective July 1, 2012.