Gastroenterologists are expecting to see Medicare payment cuts for both facility and non-facility billing for the top 10 most common GI CPT codes in 2024, according to Healthcare Appraisers' 2023 GI "Industry Outlook" report, published in September.
While facilities will see an average reimbursement reduction of between 3% and 5%, ASCs will actually see a 7% to 9% increase in reimbursements, and hospital outpatient departments will see a 5% to 6% increase.
These factors could lead to an increase in GI procedures moving to the ASC setting, according to the report.
Here is how reimbursement fees will increase or decrease by setting for the 10 most popular GI CPT codes, which are all related to esophagogastroduodenoscopy or colonoscopy:
43235
Non-facility: -4%
Facility: -3%
ASC: 7%
HOPD: 6%
43239
Non-facility: -4%
Facility: -2%
ASC: 7%
HOPD: 6%
43246
Non-facility: N/A
Facility: -3%
ASC: 9%
HOPD: 5%
43248
Non-facility: -4%
Facility: -3%
ASC: 7%
HOPD: 6%
43249
Non-facility: -5%
Facility: -3%
ASC: 9%
HOPD: 5%
45378
Non-facility: -3%
Facility: -3%
ASC: 8%
HOPD: 6%
45380
Non-facility: -4%
Facility: -3%
ASC: 7%
HOPD: 5%
45381
Non-facility: -4%
Facility: -3%
ASC: 7%
HOPD: 5%
45384
Non-facility: -4%
Facility: -3%
ASC: 7%
HOPD: 5%
45385
Non-facility: -3%
Facility: -3%
ASC: 7%
HOPD: 5%