Outpatient reimbursements getting more complex: What this means for ASCs 

Outpatient visits are being billed at increasingly higher levels, according to a Feb. 27 analysis from the Peterson Foundation and Kaiser Family Foundation. 

This increase, paired with increasingly complex coding practices, has sparked concern that healthcare providers, including ASCs, may be billing for more complex procedures than are actually being performed, the report said. 

The analysis found that the average price of an outpatient visit grew faster than inflation from 2003 to 2019 in physician offices, urgent care centers and emergency departments. 

If the distribution of claim levels had stayed consistent from 2004 to 2021, outpatient evaluation and management costs would have been 4 percent lower in 2021, the report also found. 

Overall, outpatient visits are being coded at higher levels, resulting in higher costs. 


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