Representatives from the ASC Association recently met with the Centers for Medicare & Medicaid Services on payment policies in surgery centers, according to an ASCA release.
The ASCA was joined by representatives from the American Urology Association and the American Association of Orthopedic Surgeons, including orthopedic surgeon Gregg Massanelli, MD, who practices in an Arkansas ASC.
The discussion included the following topics:
• The use of the CPI-U as the determinant for ASC payment updates. ASCA and the other organizations requested the use of the hospital market basket as a more accurate reflection of inflation.
• The uncertainty around CMS' process for the approval of procedures eligible to be performed in ASCs. The attendees requested more transparency in the approval process.
• The formula CMS uses to determine which procedures are paid as "device intensive" in ASCs. The current ASC payment system does not accommodation for the cost of devices unless the cost of the device is at least 50 percent of the average cost of the procedure in a HOPD. The threshold means some procedures that could be performed in an ASC are not done in the setting because the payment would not cover the cost.
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The ASCA was joined by representatives from the American Urology Association and the American Association of Orthopedic Surgeons, including orthopedic surgeon Gregg Massanelli, MD, who practices in an Arkansas ASC.
The discussion included the following topics:
• The use of the CPI-U as the determinant for ASC payment updates. ASCA and the other organizations requested the use of the hospital market basket as a more accurate reflection of inflation.
• The uncertainty around CMS' process for the approval of procedures eligible to be performed in ASCs. The attendees requested more transparency in the approval process.
• The formula CMS uses to determine which procedures are paid as "device intensive" in ASCs. The current ASC payment system does not accommodation for the cost of devices unless the cost of the device is at least 50 percent of the average cost of the procedure in a HOPD. The threshold means some procedures that could be performed in an ASC are not done in the setting because the payment would not cover the cost.
Related Articles on Coding, Billing and Collections:
MedPAC Final Recommendations Stand at 0.5% Payment Increase for ASCs in 2013
Coding Snapshot: Basal Cell Carcinoma
Health Insurers Suffer Due to ICD-10 Delay