3 new procedures added to the ASC covered procedure list-
Cervical Artificial Diskectomy (CPT 22856)
Second Level Cervical Diskectomy (CPT 22858)
Total Laparoscopic Hysterectomy (Uterus over 250g; CPT 58572)
Total Knee Arthroplasty removed from IPO, Inpatient-only list. Further total joint discussion to occur in future rulings.
ASC payment rate increase 1.2%; ASC payment rate now at 1.7%
The originally proposed ASC payment rate increase of 1.9% did not stand.
The rate increase of 1.2% was determined using the following: Affordable Care Act required productivity adjustment of negative 0.5% and 1.7% projected rate of inflation.
ASCs remain on the CPI-U index for inflation.
Hospital Outpatient payment rate increase of 1.35%; HOPD payment rate now at 2.7%
The originally proposed HOPD payment rate increase of 1.75% did not stand.
The rate increase of 1.35% was determined using the following: Affordable Care Act required adjustment of negative 0.75% and productivity adjustment of 0.6% update under similar ACA
cuts, and a 2.7% market basket update.
OAS CAHPS survey mandatory implementation delayed through 2018. ASC’s may participate under voluntary measures.
Quality Measures
Removed: ASC-5: Prophylactic Intravenous Antibiotic Timing; ASC-6: Safe Surgery Checklist Use, and ASC-7: ASC Facility Volume Data on Selected Procedures.
Adopted for CY 2022 payment determination: ASC-17: Hospital Visits after Orthopedic Ambulatory Surgical Center Procedures, and ASC-18: Hospital Visits after Urology Ambulatory Surgical Center Procedures. ASC-16 not adopted as proposed.
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This post was first published November 3, 2017 and was updated July 29, 2020.
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"National Medical’s coding audit identified that our previous billing partner was coding and billing our ASC claims improperly. We were actually losing money on some cases because costly implant charges were not being coded and billed correctly. National Medical was able to go back and capture significant lost revenue. Their specialized, ASC expert coders have maximized our revenue and compliance."
MEDICAL DIRECTOR | CLEVELAND, OHIO
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“I can already tell the difference in the quality of work compared to our previous billing company. The responses and willingness to help us be successful shows in how fast we receive a response, resolution and the wealth of knowledge you share with us. Thank you!”
ASC ADMINISTRATOR | FREMONT, CA
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Our clients are typically bold, ambitious leaders within the ASC market. They share our passion for results and are prepared to act decisively to achieve them.
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"National Medical’s expertise in the ASC market revealed that our contracts were reimbursing less than Medicare and in some cases only 38% of Medicare. Due to their expertise and experience, they were able to renegotiate better contracts and increase our contract reimbursement by 305%. We’re now able to bring additional cases to our center."
ASC ADMINISTRATOR | BALTIMORE, MARYLAND
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Our clients are typically bold, ambitious leaders within the ASC market. They share our passion for results and are prepared to act decisively to achieve them.
Read below to see what our clients think about us and our performance. And we highly encourage you to speak with them so that you can hear it first hand.
"Before we hired National Medical, we were handing billing in house and were averaging $811 for each surgery. In our very first year with National Medical, with the same number of cases, we have increased our cash per case to $1,400. That represents an increase of approximately $600 per case, or 73 percent, all of which is pure profit for us. In absolute terms, that means an additional $90,000 per month to us on the same number of cases."
OWNER AND CEO, SURGERY CENTER | BAKERSFIELD, CALIFORNIA
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“We have not second guessed our decision to switch billing companies once since transitioning to National Medical. Their team seems to remind us constantly why it was such a good decision!
ASC ADMINISTRATOR | SOUTHLAKE, TX
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"National Medical consistently exceeds our expectations by going above and beyond every day. Their team is proactive, highly attentive and smart. To top it off, their detailed analytics team provides us with powerful insights into our business, allowing us to make informed decisions. In short, they are the perfect partner for all of our revenue cycle needs."
CHIEF OPERATING OFFICER, SURGERY CENTER | PORTLAND, OREGON
