Medicare's new ASC payment system will likely create incentives to steer patients needing GI services from freestanding outpatient centers into the hospital setting. The American Gastroenterological Association paints a bleak picture, forecasting that the new payment system could "shift as much as 20 percent of revenue away from ASCs." Here's why: Reimbursement for colonoscopies (CPT 45378) performed in ASCs would drop from $446 to $356.54, 30 percent less than the $509.34 HOPDs receive, if Medicare sets ASC payments at 62 percent of the HOPD rates. Here's how to prepare for what looks like an inevitable loss of revenue.