Medicare reimbursements to hospital outpatient departments will rise 1.9% and payments to ambulatory surgery centers will jump 1.6% in 2012, according to the final payment rule CMS issued yesterday.
The Ambulatory Surgery Center Association greeted the news with mixed reviews. "While we are disappointed that, despite ASCA's objections, CMS continues to use a flawed measurement (CPI-U) in setting the ASC rates, we are pleased that the anemic 0.9% that bad been initially proposed has grown to 1.6% in the final rule."
Under the new rule, Medicare reimbursement for cataract surgery (CPT 66984) will increase from $951 to $963.62.
The payment rule also delays the start date of quality reporting requirements for ASCs from January 1 to October 1, 2012. ASCs will be required to report quality data - 5 quality measures, including 4 outcome measures and 1 surgical infection control measure - to ensure that surgical centers avoid a payment penalty of 2.0% in 2014.
CMS projects that total payments to more than 4,000 hospitals paid under the Outpatient Prospective Payment System (OPPS) in 2012 will be about $41.1 billion. CMS also projects that payments to about 5,000 Medicare-participating ASCs paid under the ASC Payment System will be about $3.5 billion for next year.
Dan O'Connor
