ASC Coding, Billing & Collections

If finalized, the proposed CMS 2022 Hospital Outpatient Payment Prospective System and ASC Payment System rule may have lasting ramifications for ASCs and the healthcare system.

An Arizona ASC will have to revamp its complaint against Cigna to recover $5.6 million by next month, or it will be dismissed entirely.

ASCs have long struggled to secure reimbursements — with CMS' proposal to remove 258 procedures from the ASC payable list, leaders are concerned that securing payment could become even more challenging. 

Mark Reinford predicts consolidation amongst big payers and consolidation in fee schedules in the payer market in the next five years. 

ASCs often can struggle to leverage payer contracts in comparison to larger hospitals and health systems. 

ASCs can often offer higher-quality care at lower rates, making it a prime location for direct contracting. 

The proposed 2022 Hospital Outpatient Prospective Payment System and ASC Payment System would remove 258 procedures from the ASC payable list if finalized later this year.

CMS issued the 2022 Hospital Outpatient Prospective Payment System and ASC Payment System proposed rule July 19, which includes some big updates for ASCs.

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

As higher-acuity procedures move outpatient, independent ASCs could have difficulty securing reimbursements.