CMS has proposed a 2.6% increase in payment rates in 2025 for ASCs that meet certain reporting requirements. The agency is projecting that total ASC payments will be about $7.4 billion in 2025 — an increase of more than $200 million over 2024.
Only ASCs that meet the quality reporting requirements under the ASC Quality Reporting Program would receive the rate increase.
The increased rate and funding will have an impact on cardiology as more cardiology and cardiac surgery procedures are being performed at ASCs as those surgeries are being moved toward outpatient care settings.
In the proposal, CMS is also looking to add new CPT code 0795T and code 0801T, which are codes for pacemaker insertions and removal/replacements, respectively. CMS has also proposed two new G-codes and payments for atherosclerotic cardiovascular disease risk assessment and management services, with HCPCS code GCDRA and GCDRM.
Both new rules are likely to be finalized in November, the report said.
