ASC Coding, Billing & Collections

Here are three recent rulings from CMS that affect ASCs: 

Pediatric intensivist David Lankford, MD, is suing his former employer, Fort Wayne, Ind.-based Lutheran Hospital, to get out of a noncompete clause in his contract, local PBS affiliate WFYI reported Nov. 2. 

In August, Greenville, S.C.-based Prisma Health warned its patients that starting Jan. 1, the health system might be out of network with UnitedHealthcare. Now, as the negotiation deadline looms, it seems more and more likely, according to a Nov. 3…

The average cost of employing a provider full time in the third quarter of this year was $611,194, representing a rising cost of labor, according to data from Kaufman Hall.

The average revenue earned by physicians and advanced practice providers via treating patients is on the rise, according to data from Kaufman Hall.

CMS added 11 procedures to the ASC-covered list in the ASC Payment System Final Rule released Nov. 2 that were not included in the proposed rule. 

CMS has finalized a 3.1% payment rate for ASCs. 

CMS will reduce overall physician pay 1.25% in 2024, while boosting pay for some visits including primary and longitudinal care.

Reimbursement issues remain one of the top challenges for physicians across specialties.

In August, UnitedHealthcare announced plans to reduce 20% of its prior authorization requirements for its members and member physicians beginning on Sept. 1.