On July 15, CMS released its new rules for 2026, including the proposed addition of more than 200 procedures to the covered procedures list for ASCs.
This news was particularly celebrated within the cardiology community, as professional and physician advocacy organizations, such as the American College of Cardiology and the Heart Rhythm Society, among others, have long-advocated for certain cardiology procedures to be added to the ASC-CPL list. They believe that advancements in medical techniques and technology have made cardiovascular procedures, such as the newly ASC-approved cardiac ablations, safer to perform in the outpatient setting.
“The addition of EP ablation is a big win for cardiology,” said Tracy Helmer, administrator of Mesa, Ariz.-based Tri-City Surgical Centers told Becker’s. “There’s been a lot of work with that over the last number of years to show the efficacy and safety profile for those particular procedures.”
Mr. Helmer, who came to cardiology from a multispecialty practice, said orthopedics is another specialty that is likely to see growth from the recent CMS proposal. CMS also proposed phasing out the inpatient only list, beginning with the removal of 285 mostly musculoskeletal procedures. Most of these will be added to the CPL list for ASCs.
“I think there will continue to be growth in the orthopedic space, right alongside cardiology,” he said. “When you look at 3D printing, AI and … the ability to care for patients at a much higher level of efficiency, I think those types of technologies are exactly what aligns with the overall goals of Medicare.”
The announcement overall is a “strong message” of support for ASCs, Mr. Helmer added, based on the number of procedures added alone. Moving forward, he said it will be vital for private payers to pay attention to this move and reflect on their own payment policies “for their own efficiency and to create access for their patients.”
There were still certain procedures and issues that Mr. Helmer was surprised to see go unaddressed in the recent policy proposal.
“I was surprised that they did not fix an error that was made last year, when they removed coronary lithotripsy. This proposed rule was released without putting it back on the proposed list. The procedure was being done with high levels of safety and efficiency for patients,” he said.
“The other procedure that is keeping many patients out of the ASC setting is diagnostic peripheral angiography, being that the only way a patient can get this type of procedure is if they have an intervention done. So, the many thousands of people that need diagnostic studies simply cannot benefit from the ASC, as they are not able to get their diagnostic procedure done in the centers,” he added. “Adding that diagnostic code would allow for many more patients to receive diagnostic care.”
The addition of these procedures would create savings for the Medicare program, he said, “as well as [provide] safe and effective care pathways for patients to receive excellent alternatives to the hospital for these types of procedures.”
