Here are five recent CMS moves that are shaping the ASC industry:
1. In its 2024 Physician Fee Schedule Final Rule released Nov. 2, CMS finalized a 3.1% payment rate for ASCs. The rate is based on the projected hospital market basket increase of 3.3%, reduced by 0.2% for the productivity adjustment.
2. The rule also added 11 procedures to the ASC-covered list that were not included in the proposed rule, including total shoulder arthroplasty. ASC leaders were concerned after CMS released its proposed rule in July, which added only 26 dental codes to the ASC-payable list.
3. Additionally, CMS will reduce overall physician pay 1.25% in 2024 while boosting pay for some visits, including primary and longitudinal care. It updates the conversion factor to $32.74, a 3.4% decrease over last year.
4. CMS settled a record number of 104 Stark law self disclosures in 2022, totaling more than $9.2 million — nearly quadruple the number of settlements in 2021. According to an article published by JDSupra, this could mean "CMS is working to review a greater number of self-disclosure submissions annually, which may reduce the backlog or the time it takes to have a self-disclosure reviewed."
5. CMS proposed maintaining the waiver of geographic and originating site restrictions related to telehealth through the end of 2024. The waiver will allow Medicare beneficiaries to connect with physicians anywhere in the U.S. from home.