The ASC sector has seen continued increases in CMS payment rates as procedures continue to shift to the outpatient setting, according to VMG Health's 2024 Healthcare M&A Report published May 7.
Here are five notes on shifting Medicare reimbursements for ASCs, according to the report.
1. In November 2022, CMS increased the ASC conversion factor by 3.8% for 2023, a substantial increase from the year prior that increased payment rates by 2%.
2. In November 2023, CMS updated the rule for 2024, which resulted in overall expected growth in payments equal to 3.1%, according to the report. This increase is based on a projected inflation rate of 3.3% minus a reduction of 0.2% under the Affordable Care Act.
3. "The 3.1% growth in payments represents a continuation of elevated increases in projected payments compared to years prior to 2023, a direct result of the increase in labor, supplies, and other cost pressures seen over the last two years," the report added.
4. In the 2023 final rule, CMS considered 64 recommendations for new procedures to be added to the ASC Covered Procedure List, but only added four codes.
5. In the 2024 final rule, CMS finalized the addition of 37 surgical procedures to be added to the ASC list, including 26 dental codes and 11 surgical codes that were not included in the proposed rule — notably total shoulder arthroplasty.