CMS Proposes 0% Change in 2011 ASC Payment Rates

Ambulatory surgery centers would see a 0% increase in Medicare payments next year under the Centers for Medicare and Medicaid Services' 2011 proposed payment rule for ASCs and hospital outpatient departments. The proposed market basket update for hospital outpatient departments in 2011 is 2.15%.

Next year marks the final transition to the revised Medicare payment system for ASCs and is also the scheduled implementation year for several provisions of the Affordable Care Act (ACA) that affect HOPD and ASC reimbursement rates.

CMS based its proposed net-zero inflation update for ASCs in 2011 on the 1.6% estimated increase in the consumer price index, coupled with the -1.6% productivity adjustment CMS must now apply to ASC payment rates under ACA.

The ASC Advocacy Committee says the 0% change for ASCs is "inconsistent with MedPAC's recommended update of 0.6%," and the organization plans to "vigorously protest" the proposed rule.

In another change mandated by ACA, the proposed rule also waives the deductible and coinsurance for most Medicare-covered preventive services, such as colonoscopies, performed in ASCs and hospital outpatient departments. Medicare beneficiaries will be fully covered for such procedures as of 2011.

Irene Tsikitas