AMBULATORY SURGICAL CENTERS

Medicare currently reimburses Ambulatory Surgical Centers (ASCs) for facility costs on the basis of a fee schedule that groups a specific list of outpatient surgical procedures into one of nine groups, each with an associated reimbursement rate.

In calendar year 2008 the Centers for Medicare & Medicaid Services (CMS) will greatly expand the number of procedures it will pay for in an ASC and start a four-year transition linking ASC payments to the outpatient hospital prospective payment system (HOPPS). ASCs will be paid 65% of what a hospital is paid for the same surgical procedure.  Exceptions will include “office-based” procedures, those predominately performed in a physician office setting, which will be capped at the rates they would be paid to physicians. The CY 2008 HOPPS final rule contains final 2008 payment rates for ASCs.

NEWS

11/27/2007:: CY 2008 Medicare interim final rule on Hospital Outpatient Prospective Payment System with updates to the CY 2008 Ambulatory Surgical Center Payment System published. Summary available to OHA members only.

8/02/2007 :: CMS’ final rule on the CY 2008 Medicare ambulatory surgical center payment system published.