ASC Coding, Billing & Collections

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…

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…

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…

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…