ASC Coding, Billing & Collections

Here are six updates on Medicare Advantage that have made headlines recently, as reported by Becker's since June 25:

Reimbursement differences between hospital outpatient departments and ASCs are a longstanding point of contention among ASC professionals, with Medicare ASC payments increasing only marginally while Medicare hospital pay has seen comparatively significant jumps.

Medicaid patient counts for self-employed and employed physicians were substantially lower than Medicare, according to Medscape's 2024 "Doctors Evaluate Medicare and Medicaid Report 2024," published July 12. 

Earlier this year, Congress reduced physician pay rates under Medicare Part B by 1.7%, following a 2% cut in physician reimbursements in 2023. 

Nearly half of physicians are in support of accepting more Medicare patients at their practice, according to Medscape's 2024 "Medscape Doctors Evaluate Medicare and Medicaid Report 2024," published July 12. 

As more procedures gain approval to be conducted on an outpatient basis, reimbursement differences between various care settings have gained significant attention in the healthcare industry — among patients, executives and clinicians alike. 

Cataract excision surgery with removal of lens, without endoscopic cyclophotocoagulation, was the most frequently conducted procedure at ASCs in 2023, according to an analysis by healthcare market intelligence company Definitive Healthcare.

The burden of prior authorization is growing as "payers seek new strategies to reduce outlays," according to a June 24 blog post from Coronis Health. 

The federal government is targeting New York City-based Mount Sinai Health System's inclusion of noncompete clauses in contracts for part-time physicians in a June 18 complaint filed with the National Labor Relations Board. 

The Federal Trade Commission's ban on noncompete clauses is facing a preliminary injunction from a federal court in Texas.