ASC Coding, Billing & Collections

CMS’ proposed Medicare payment policy includes another 1.68% cut to reimbursements for surgeons.  The CMS calendar year 2027 Medicare Physician Fee Schedule’s proposed rule could have an even larger effect on spine and orthopedics. Specialty-level analysis estimates that orthopedic surgery…

On July 14 CMS  issued a proposed rule outlining Medicare Part B payment policy changes for physicians and other practitioners under the calendar year 2027 Physician Fee Schedule, including a 1.68% decrease in the proposed conversion factor for non-qualifying alternative…

EyePoint Pharmaceuticals has agreed to pay the U.S. government $4,657,463.18 to resolve False Claims Act allegations tied to its ophthalmic drug DEXYCU. According to a July 17 news release by the Justice Department, the Waltham, Mass.-based company allegedly paid kickbacks…

A two-paragraph provision in North Carolina’s new state budget has left oral health advocates uncertain about its implications for Medicaid coverage of dental procedures performed at ASCs, North Carolina Health News reported July 17. Five notes:

While ASCs have seen significant growth in recent years as CMS approves more procedures for the outpatient setting, technology advances and patient preferences shift — insurer policies and practices remain a key obstacle to ASC growth and sustainability.  Two ASC…

An operation can go exactly as planned and still become a bad surgical episode. The patient leaves the hospital, then falls at home. Pain or swelling sends them to the emergency department. A rehabilitation stay stretches longer than expected. A…

After exhausting the standard playbook of renegotiating contracts and tightening inventory, the next layer of ASC savings may be hiding in plain sight. Maximizing workflow efficiencies and available labor are two areas where leaders can look to once the easy…

CMS has spent 2026 building a public case that its Medicaid program integrity crackdown is paying off, including a $1.3 billion funding deferral to Minnesota, provider revalidation orders sent to all 50 state governors, and a jump in Medicare program…

CMS has framed its proposed 2027 Medicare physician payment rule as a pivot from “sick care to healthcare.” For orthopedic and spine practices, the proposal carries a more immediate message: The widely reported 1.68% reduction to Medicare’s physician conversion factor…

CMS on July 14 issued a proposed rule outlining Medicare Part B payment policy changes for physicians and other practitioners under the calendar year 2027 Physician Fee Schedule, with changes proposed to take effect Jan. 1, 2027. Here are seven…