CMS’ addition of more than 560 codes to the ASC covered procedure list for 2026 is a milestone for the industry, but SCA Health executives say the real impact, particularly for cardiovascular services, will take time to materialize.
The additions include 289 procedures already paid in hospital outpatient departments and 271 procedures coming off the inpatient-only list. The newly covered services include cardiovascular codes for electrophysiology studies, and ablations and percutaneous coronary intervention, as well as spinal codes such as posterior lumbar interbody fusion.
SCA Health leaders told Becker’s that while the expansion is directionally significant, especially for cardiovascular ablation procedures, adoption will depend heavily on geography, physician alignment and facility readiness.
“We’ve been pushing for cardiovascular codes for a while, so those are the most exciting part of this update for us,” Lindsay Lowder, group vice president of operational innovation and strategy at SCA Health, told Becker’s. “That said, we’re not going to see an immediate impact, because that service line requires significant operational ramp-up and physical plant readiness. It’s not like flipping a switch.”
CMS’ 2026 covered procedure list expansion includes a substantial number of newly eligible procedures, but cardiovascular codes are among the most consequential for ASC operators. The specialty has historically remained concentrated in hospital outpatient departments due to reimbursement, infrastructure and physician employment dynamics.
A scientific statement published by the Journal of the American College of Cardiology in November 2025 describes electrophysiology as the next specialty poised for site-of-care migration, similar to interventional cardiology’s path before CMS expanded ASC coverage for cardiac catheterization and percutaneous coronary intervention in 2020.
Ms. Lowder said while SCA Health views the addition of cardiovascular procedures as a long-term opportunity, centers will need time to prepare facilities and build the necessary clinical programs before case volumes shift meaningfully.
“We won’t see CV volume immediately flowing into centers, but it’s a very important shift and one the industry has prioritized for a long time,” she said. “We’re excited to see CMS bring that service line further into the ASC space.”
Matthew Humbarger, group vice president of payer engagement and strategy at SCA Health, said the company is particularly encouraged by the addition of cardiovascular ablation codes, which reflect broader clinical advancements and evolving site-of-care trends.
“We’re very pleased with the 2026 covered procedure list, especially the addition of cardiovascular ablation codes,” Mr. Humbarger said. “These are procedures we’ve been focused on for years, and we’ve had conversations with commercial payers about removing payment barriers. CMS’ move is a step in the right direction to align reimbursement with clinical advancements.”
Still, executives emphasized that case mix shifts will vary widely by market.
“It’s very geography-specific,” Mr. Humbarger said.
Ms. Lowder pointed to regulatory variation and physician employment patterns as key factors influencing adoption timelines. States such as Texas and Florida, which have fewer regulatory barriers, may see faster movement of cardiovascular procedures into the ASC setting. Other markets could face a slower transition due to certificate-of-need laws or hospital employment structures.
Other states will move more slowly. New York, for example, prohibits cardiovascular services in ASCs and requires atrial fibrillation and ventricular tachycardia ablations in facilities with on-site cardiothoracic surgical support.
Additionally, even with ablation now ASC-eligible, key supporting services, including transesophageal echocardiography and cardioversion, are not on the ASC-covered procedures list, according to JACC. Without those capabilities in the same setting, care pathways can become fragmented.
“There are a lot of steps — facility readiness, physician relationships, and the fact that many cardiologists are employed by hospitals,” Ms. Lowder said. “It’s really doctor by doctor. That’s why it takes time.”
She added that physicians must weigh whether independent or ASC-aligned practice models make sense in their local markets, and in some cases, discussions with health systems about partnership structures will shape the pace of migration.
“The addition of these codes alone won’t drive the change, but it’s an important piece of the overall equation,” Ms. Lowder said.
