Here are four billing and coding updates with the potential to impact ASC reimbursement:
CMS proposal could drastically expand procedure options. CMS proposed several updates to ASC payments in the 2019 proposed payment rule, issued July 25. One of the key changes for ASCs would be to broaden the definition of device-intensive procedures, adding around 131 procedures for Medicare beneficiaries in the ASC setting. Read more.
Payment might drop for specialty physician' complex cases. CMS' proposed 2019 Medicare Physician Fee Schedule involves significantly lowering reimbursement for complex cases often seen by specialty physicians during office and outpatient visits. Read more.
Medicare continues adding codes for interventional radiology ASCs. Interventional radiology ASCs have more ways than ever to collect for procedures, thanks to a surge in the number of billing codes supporting these facilities. This year, Medicare added 176 for a total of more than 413 irASC CPT codes. Read more.
New Jersey enacts out-of-network billing law. The Out-of-Network Consumer Protection, Transparency, Cost Containment and Accountability Act requires healthcare facilities and providers to notify patients if they are out-of-network before scheduling a non-emergency appointment — which would apply to appointments at ASCs. Read more.