The Centers for Medicare and Medicaid Services has released its final 2015 ASC payment rule, according to an Ambulatory Surgery Center Association of Illinois report. Here are five things to know about the final rule.
1. ASCs payment rates will rise 1.4 percent in 2015. The bump in payment is based on a 1.9 percent expected rate of inflation minus a 0.5 percent productivity adjustment, as required by the Patient Protection and Affordable Care Act.
2. The payment increase is 0.2 percent higher than the 1.2 percent update included in the Medicare proposed rule. The proposed increase was based on projected inflation of 1.7 percent minus the 0.5 percent adjustment.
3. Previously, CMS defined device-intensive procedures as those in which the device cost accounted for more than 50 percent of the total procedure cost. In the 2015 final rule, CMS updated ASC device-intensive procedures as those in which the device cost accounts for more than 40 percent of the total procedure cost. At the 50 percent threshold, there were 163 procedures in an ambulatory payment classification that were not performed in ASCs due to lack of adequate reimbursement, according to the report. Now at the 40 percent threshold, there are 48 codes that are still prohibitive due to device costs.
4. CMS also made ASC-11: Cataracts: Improvements in Patient's Visual Function within 90 Days Following Cataract Surgery a voluntary measure for the ASC Quality Reporting Program. The final rule also finalized the proposed quality measure ASC-12: Facility Seven-Day Risk-Standardized Hospital Visit Rate After Outpatient Colonoscopy.
5. The final deadline, as mandated by the final rule, for ASC-8: Influenza Vaccination Coverage Among healthcare Personnel is May 15, 2015. The quality measure must be reported through the National Healthcare Safety Network.