Medicare 2025 reimbursement updates: 6 things to know

From 2011 to 2024, the number of Medicare-certified ASCs in the U.S. grew from 1,339 to 2,140, according to VMG Health’s “ASCs in 2024: A Year in Review,” report.

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Here are six Medicare reimbursement updates for ASCs to know: 

1. On Nov. 1, 2023, CMS finalized its 2024 ASC reimbursement fee schedule, causing concern from ASC leaders who believe that rising operational costs cannot keep up with declining reimbursements. 

2. On Jan. 1, CMS introduced a 2.9% payment increase for ASCs. ASC leaders still believe the hike is too modest to keep pace with inflation. 

3. ASC annual net inflation adjustments since 2016: 

  • 2016: 0.3%
  • 2017: 1.9%
  • 2018: 1.2%
  • 2019: 2.1%
  • 2020: 2.6%
  • 2021: 2.4%
  • 2022: 2.0%
  • 2023: 3.8%
  • 2024: 3.1%
  • 2025: 2.9%

4. Medicare payments for the 10 most common ASC procedures are projected to increase by 3.4% from 2024 to 2025.

5. Some procedures are witnessing larger changes, including a 7% increase for esophagogastroduodenoscopy biopsies and a 5% increase for spinal neurostimulator procedures.

6. CMS projects that ASC payments in 2025 will increase to $7.4 billion, $308 million more than 2024. 

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