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Medicare's 2020 ASC Proposed Payment Rule Released

Medicare’s 2020 ASC Proposed Payment Rule Released

The Centers for Medicare & Medicaid Services (CMS) released this week (July 29) the 2020 proposed payment rule for ASCs and hospital outpatient departments (HOPDs).

Of note, CMS has proposed to add eight codes to the ASC-payable list, including total knee arthroplasty (TKA) and several cardiology codes.

CMS also proposed to continue to align the ASC update factor with that used to update HOPD payments. Under the proposal, CMS would continue to use the hospital market basket to update ASC payments for calendar year (CY) 2020 through CY 2023 as the Agency assesses this policy’s impact on volume migration.

If the proposed rule were to be finalized as drafted, ASCs would see, on average over all covered procedures, an effective update of 2.7 percent—a combination of a 3.2 percent inflation update based on the hospital market basket and a productivity reduction of 0.5 percentage points mandated by the Affordable Care Act. Please note that this is an average, and that updates may vary significantly by code, specialty and additional reductions due to federal budgeting sequestration.

The OAASC's annual conference in September will provide you a full overview of all of the changes. Additionally, we will be asking members to submit comments based on the national ASC Association's (ASCA) comprehensive review and in support of ASCA's and OAASC's comments in September late.


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Content courtesy of ASCA Government Affairs


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