What ASC leaders need to know about the 2023 CMS final rule

CMS released its finalized 2023 Physician Fee Schedule on Nov. 1. Here are five things ASC leaders need to know.

Payment rates

1. Medicare's physician fee schedule final rule will reduce the physician pay conversion factor by 4.48 percent to $33.06.

The conversion factor used to calculate physician reimbursement will decline by $1.55 in 2023. With the 4 percent statutory Pay-As-You-Go sequester, which was implemented to offset congressional spending outside of healthcare, physicians are looking at an 8.5 percent pay cut.

2. CMS finalized the productivity-adjusted hospital market basket update to ASC payment system rate with an updated ASC payment rate of 3.8 percent applied to ASCs meeting relevant quality reporting requirements.

It is also increasing outpatient payment rates for hospitals that meet applicable quality reporting requirements by 3.8 percent.


1. CMS will increase the pay rate for iTind procedures in ASCs and hospital outpatient departments. CMS finalized an average pay rate of $8,221.74 per procedure in HOPDs and $7,274.78 per procedure in ASCs.

2. CMS is expanding Medicare coverage for certain colorectal cancer screening tests by reducing the minimum age payment and coverage limitation from 50 to 45.

It is also expanding the regulatory definition of colorectal cancer screening tests to include a complete colorectal cancer screening, where a follow-up colonoscopy screening after a Medicare covered noninvasive stool-based colorectal cancer screening test comes back positive. For most beneficiaries, cost sharing will not apply for either the initial stool-based test or the follow-on colonoscopy.

3. CMS added four new procedures to the list of covered ASC procedures. The procedures are: 19307, mast mod rad; 37193, rem endovas vena cava filter; 38531, open bx/exc inguinofem nodes; and 43774, lap rmvl gastr adj all parts.

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