ASC Coding, Billing & Collections

ASCs' payer issues aren't new, but many are now  increasingly challenged by complex and restrictive payment policies set by insurers. 

Physicians are spending more time than ever on prior authorizations for treatments and procedures, which many say has a negative impact on patient care. 

CMS began requiring hospitals to report specific admission information on Nov. 1. 

On Nov. 1, CMS finalized the 2025 Medicare Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System rule, confirming a 2.83% physician pay cut.

CMS finalized a 2.83% physician pay cut in its 2025 Medicare Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System released on Nov. 1. 

CMS issued the 2025 Medicare Hospital Outpatient Prospective Payment System and Ambulatory Surgical Center Payment System final rule Nov. 1, with slight pay bumps in each setting despite continued inflation and specialist shortages.

House Rep. Greg Murphy, MD, has introduced a bill that would stabilize pay under Medicare for 2025. 

Denials of claims are increasing, along with the administrative burden of managing them. 

ASCs and hospitals are increasingly joining forces as healthcare consolidation accelerates, and more procedures shift to outpatient settings, driven by payer preferences and patient demand for lower-cost alternatives. 

In an Oct. 16 opinion piece published in MedpageToday, Nehad Soloman, MD, a Glendale, Ariz.-based rheumatologist writes that fees for electronic fund transfers on payments made at medical practices "cut into practices' often razor-thin margins as they struggle to stay…