1 From 9 grouper rates to 1,000 APCs.; 2 CMS will dramatically expand the number of services paid in ASCs.; 3 ASC payment rates will be a constant percentage of the OPPS rates.; 4 ASC payment rates will be automatically revised in the future.; 5 High-cost implants might be feasible.; 6 Numbers still subject to change.; 7 Four-year transition.; 8 GI and pain management take a hit.; 9 What about hospitals?; 10 To prevent economic incentives from biasing site choice...; Cases will continue to migrate to ASCs; APCs; APCs. Medicare; ASC; ASC Payment System POLICY EXAMPLE IMPACT ASCs Separately Paya... show all keywords1 From 9 grouper rates to 1,000 APCs.; 2 CMS will dramatically expand the number of services paid in ASCs.; 3 ASC payment rates will be a constant percentage of the OPPS rates.; 4 ASC payment rates will be automatically revised in the future.; 5 High-cost implants might be feasible.; 6 Numbers still subject to change.; 7 Four-year transition.; 8 GI and pain management take a hit.; 9 What about hospitals?; 10 To prevent economic incentives from biasing site choice...; Cases will continue to migrate to ASCs; APCs; APCs. Medicare; ASC; ASC Payment System POLICY EXAMPLE IMPACT ASCs Separately Payable Radiology Services. CMS; ASC. Cases; ASC. Separate ASC; ASCs; ASCs Separately Payable Radiology Services. CMS; ASCs CMS; ASCs, HOPDs; ASCs. New; Administered. Report; Anesthesia; Botox; CCS Ms. Jones; CMS; CMS, Medicare; CPT; Category CPT; Category III CPT; Code; Discontinued; Discontinued Anesthesia; Drugs; Four-year; GI; HCPCS; HOPDs; High-cost; II HCPCS; III CPT; January, Medicare; Jones; Jones, RHIA, CCS Ms. Jones; Key Policies; Level II HCPCS; Lolita M. Jones, RHIA, CCS Ms. Jones; M. Jones, RHIA, CCS Ms. Jones; Medicare; Medicare's; Numbers; OPPS; OPPS. Radiology; OR. Anesthesia; Payable Drugs; Payable Radiology Services. CMS; Payment System POLICY EXAMPLE IMPACT ASCs Separately Payable Radiology Services. CMS; Payments; Policies; Procedures; RHIA, CCS Ms. Jones; Radiology; Radiology Services. CMS; Report; Requiring Anesthesia; Separate ASC; Services; Services. CMS; Spending; Starting; Surely; System POLICY EXAMPLE IMPACT ASCs Separately Payable Radiology Services. CMS; ability; accommodate; actuaries; add; added; adjustment; administration; advantage; ambulatory; amounts; anal; ancillary; anesthesia; appended; areas; arrangement; assumes; attractive; audits; author; automated; automatically; based; biasing; bill; billed; biologicals; biopsy; blunt; brachytherapy; bradycardia; break; breast; budget; calculated; calendar; care; carriers; cataract; change; changed; chest; choose; clinical; closure; code; coding; completed; complex; complicated; components; constant; continue; costs; cover; covered; cuff; current; day; decided; decline; degree; dehiscence; delivered; delivers; design; determine; develops; difference; direct; directed; discontinued; dramatically; drugs; due; economic; economically; effect; established; estimate; estimates; exclude; existing; expand; expanded; expected; expense; expensive; extensive; eye; face; facilities; facility; facility-level; fee; final; four-year; full; fully; gastrointestinal; general; goal; grouped; grouper; guidance; half; high; high-cost; higher; hospital; identified; imaging; implantable; implants; improved; incentives; inception; include; incurred; initiated; initiation; injection; insertion; insure; integral; interrupted; items; justified; key; lead; limited; linkage; list; made; magnitude; make; management; method; migrate; million; modifier; month; move; needle; neutral; newly; number; numerical; obligations; office; office-based; offices; open; opportunity; outpatient; pacemakers; paid; pain; parameters; part; partly; patient; pay; payment; payments; pays; percent; percentage; performance; performed; performs; physician; physicians; planned; policies; policy; practice; predominantly; prepared; prevent; primarily; primary; procedure; procedures; projected; proportion; proposed; prospective; provide; providing; put; quality; radiological; radiology; range; rate; recalibrated; receive; reflect; regulation; reimburse; reimbursement; relative; released; relocation; repair; report; represented; require; requiring; response; result; revised; rise; risky; rotating; rotator; routinely; rules; safety; scheduled; secondary; secular; self-referral; separate; separately; service; setting; she's; show; sides; sigmoidoscopy; significant; site; spending; standards; subject; submucosal; substantial; supervision; surgery; surgical; system; technology; thought; time; toxin; transition; two-thirds; type; uncompensated; undergoes; updated; vacuum-assisted; values; virtually; volume; weights; wind; wound
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Starting in January, Medicare will make the most extensive changes in payment for ambulatory surgery facility services since the inception of the program. Under regulations released last month from the CMS, Medicare will pay ASCs in virtually the same method - though not at the same amounts - that it pays hospital outpatient departments. A primary goal of these changes is to lead physicians and patients to determine the best site of service for surgical services based on safety and quality of the care rather than on the reimbursement or co-payment. It's expected that, over time, there will be a substantial relocation of services among ASCs, HOPDs and physicians' offices. Here, we break down 10 key components of the new system.
