Next month, a federal commission called MedPAC will deliver a one-two punch to ambulatory surgery centers. MedPAC will recommend to the U.S. Congress that it eliminate annual inflationary updates to ASCs and lower the roughly 300 ASC rates that are higher than hospital outpatient department (HOPD) rates so that no ASC rate is greater than an HOPD rate. If Congress follows MedPAC's advice (history suggests that it will), all ASCs would feel the pinch:
- Overall, ASC payments would decrease by 7% (based on current HOPD and ASC reimbursements).
- Reimbursements would drop for about half of the Medicare-reimbursed cases that ASCs perform.
- For the roughly 300 CPT codes that would be capped at current HOPD rates, the average payment reduction would be 20 percent.
- Single-specialty ophthalmology and endoscopy centers that do the high-volume procedures that MedPAC has targeted for the deepest cuts would be hit the hardest.
