CMS’s proposed 2027 payment rule includes a 2.4% overall bump for ASCs. That number represents an average across hundreds of codes, and it collapses two things that are moving in opposite directions for different specialties: which procedures get approved for…
ASC Coding, Billing & Collections
Providence Health Plan’s decision to wind down most of its insurance business starting in 2027 is the latest example of a payvider model failing, and it raises a question of who controls where patients go next when the health system…
More physicians are moving procedures out of hospitals and ASCs and into freestanding, cash-pay, office-based surgery centers, a shift plastic surgeon Heather Levites, MD, attributes to lower buildout costs and a growing comfort with lighter anesthesia. The share of surgeons…
Six New Jersey defendants, including a pharmacy owner, an emergency medicine physician and several advanced practice nurses, have been charged in connection with a scheme that caused more than $20 million in losses to Medicare and Medicaid through illegal kickbacks…
CMS’ proposed 2027 payment rule, and its continued phase-out of the inpatient-only list opens the door for more procedures to move into ASCs — but not every practice is positioned to walk through it. David Carmichael, administrator and CEO of…
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CMS’ 2027 payment rule for ASCs, proposed July 2, projects a 2.4% effective update overall — the same headline figure hospital outpatient departments are set to receive. But that number masks sharply different outcomes depending on procedure type, according to…
A new analysis from Marit Health breaks down physician compensation by specialty and training length, analyzing the number of years spent in residency compared with the eventual paycheck. Here are five things to know: 1. The average medical school graduate…
Payer consolidation has accelerated to a pace that most ASC administrators did not build into their contracting assumptions. Cigna sold its Medicare Advantage business to Health Care Service Corp. in 2025. Smaller Blues plans are affiliating with larger ones. Health…
A Memphis gynecologic oncologist has been sentenced to 20 years in prison for using dirty, reused medical devices on more than 15,000 women during hysteroscopy procedures and billing Medicare and Medicaid more than $41 million for the unsafe care, the…
ASC leaders warn a proposed CMS rule aimed at rooting out Medicare fraud could have an unintended consequence, leading them to lose enrollment because of where they operate. Tucked inside the CY 2027 Home Health Prospective Payment System proposed rule,…