CMS released last week the final rule that will determine ASC and HOPD payments in 2013. ASCA, the leading association representing the ambulatory surgery center industry, released an analysis of the payment rule that can be found here.
In 2013, ASCs will see an update of 0.6 percent, which combines a 1.4 percent inflation updated based on CMS' estimation of the change in CPI-U and a productivity reduction managed by the healthcare reform law. CMS originally proposed a 1.3 percent increase, which would have been preferable to the final decision.
Other factors, such as changes in the relative costs of procedures and changes in wage index values, will also affect what an individual ASC can receive for a given procedure in 2013.
In 2013, ASC and HOPD payment rates will continue to diverge, as CMS continues to implement policies of using different measures of inflation for the two systems and reducing ASC rates through the process of secondary rescaling.
CMS acknowledged that the CPI-U is a flawed system for updating ASC payment rates, as it is highly weighted for housing and transportation and does not reflect inflation in the cost of providing ASC services, but failed to adopt the hospital market basket as the measure of inflation for ASCs.
CMS also solicited feedback in the proposed rule on the feasibility of cost reporting for ASCs, but did not take action towards establishing cost reporting.
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CMS' Medicare Final Rule Increases ASC Payment Rates by 0.6%
In 2013, ASCs will see an update of 0.6 percent, which combines a 1.4 percent inflation updated based on CMS' estimation of the change in CPI-U and a productivity reduction managed by the healthcare reform law. CMS originally proposed a 1.3 percent increase, which would have been preferable to the final decision.
Other factors, such as changes in the relative costs of procedures and changes in wage index values, will also affect what an individual ASC can receive for a given procedure in 2013.
In 2013, ASC and HOPD payment rates will continue to diverge, as CMS continues to implement policies of using different measures of inflation for the two systems and reducing ASC rates through the process of secondary rescaling.
CMS acknowledged that the CPI-U is a flawed system for updating ASC payment rates, as it is highly weighted for housing and transportation and does not reflect inflation in the cost of providing ASC services, but failed to adopt the hospital market basket as the measure of inflation for ASCs.
CMS also solicited feedback in the proposed rule on the feasibility of cost reporting for ASCs, but did not take action towards establishing cost reporting.
Related Articles on Coding, Billing and Collections:
10 Key Steps to Managed Care Contracting
7 Questions to Ask EHR Vendors About ICD-10
CMS' Medicare Final Rule Increases ASC Payment Rates by 0.6%