Pain management ASCs had a 54% net collection rate in 2025, well below the 87% average across specialties, according to HST Pathways’ 2026 State of the ASC Industry Report.
The report draws on data from 682 surgery centers in 45 states.
Here are six things to know:
1. Pain’s 54% rate was the lowest the report named, despite improving.
2. The overall net collection rate rose from 81% in 2024 to 87% in 2025. Almost all of that gain came from pain, total joint and spine, the report said.
3. Spine reached 73% and is still well behind most other specialties. Ophthalmology and orthopedics declined slightly. Gastroenterology and gynecology were close to 100% net collection.
4. Centers with 10 to 14 ORs had a 73% net collection rate, the lowest of any size group the report named.
5. Follow-up on older accounts falls off sharply. In 2025, 92% of accounts aged 0 to 30 days were worked, compared with 50% of accounts aged 31 to 120 days and 38% of older accounts.
6. Some accounts sat untouched for up to 87 days. The report recommends a more technology-driven approach to revenue cycle management, as payers use automation and AI to scrutinize and deny more cases.
At the Becker’s 32nd Annual Meeting: The Business and Operations of ASCs, taking place October 29-31 in Chicago, ASC leaders, surgeons and healthcare executives will explore strategies to drive growth, enhance operational performance, navigate reimbursement challenges and prepare for the future of ambulatory surgery. Apply for complimentary registration now.
