Despite promising changes from CMS, reimbursement will be the biggest challenge for ASCs in 2019, according to 247 Medical Billing Services.
A recap of coding, billing and reimbursement changes affecting ASCs:
1. CMS' 2019 proposed payment rule for ASCs includes an average 2.1 percent reimbursement rate increase on all covered procedures.
2. The agency also lowered the bottom line for device-intensive procedures from 40 percent to 30 percent, and decided to offer separate payments for non-opioid pain management drugs.
3. CMS proposed adding 12 cardiac catheterization procedures to the current ASC covered list and revising the definition of "surgery" to include surgery-like procedures.
4. ASC-8 will be removed from the ASC Quality Reporting Program in 2020, and ASC-10 will be removed in 2021, creating the potential for Medicare payment reductions.
5. In 2018, the American Medical Association added 170 new codes, deleted 82 codes and revised 60 codes.