MedPAC Continues Discussion of Payment Cap for Pain Management Services

The Medicare Payment Advisory Commission continues to discuss site-neutral payments for similar services provided by Medicare, according to an ASCA report.

At the group's November meeting, staff updated the commission on their analysis of a proposal that would lower HOPD rates for certain procedures to a fee based on the difference between the physician fee schedule non-facility and facility payment rates.

A month earlier, the MedPAC staff identified 86 APC groups to which this policy would apply. The groups included those that provide pain management services and laser eye surgery. In the new analysis released in November, APC groups with a high percentage of 90-day global periods were removed from the policy.

The revised analysis removed laser eye surgery from the capping policy but kept pain management services — a respective win and loss for ASCs. The Commission asked the staff to continue their analysis and report back in December.

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