CMS issued its final rule
CMS ruled Wednesday, November 1, 2017, on the Hospital Outpatient Prospective Payment System (PDF). The 1,133-page document contains the following key takeaways for ASCs:
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.
National Medical will post-legislative updates as they become available. Subscribe to be the first to know.
To navigate back to the regulatory affairs webinar – Return to the webinar.
See what’s ahead for ASCs by viewing our industry insights.
This post was first published November 3, 2017 and was updated July 29, 2020.
