CMS has released the 2017 proposed payment rule for ambulatory surgery centers (ASCs)and under the proposed rule, ASCs would see an effective update of 1.2%, according to the ASC Association (ASCA). The update is a combination of a 1.7% inflation update based on CMS’ estimation of the change in Consumer Price Index for All Urban Consumers (CPI-U) and a productivity reduction mandated by the Affordable Care Act of 0.5 percentage points, ASCA said.
CMS proposes adding eight procedures to the ASC list of payable procedures for 2017, according to ASCA. This list includes five codes that are payable in the hospital outpatient department (HOPD) setting, as well as three codes that are on the inpatient-only list.
“Unfortunately, all of these codes are add-on codes, and thus will not be separately payable,” ASCA said in a released statement.
These codes are:
- 20936 (Sp bone agrft local add-on);
- 20937 (Sp bone agrft morsel add-on);
- 20938 (Sp bone agrft struct add-on);
- 22552 (Addl neck spine fusion);
- 22840 (Insert spine fixation device);
- 22842 (Insert spine fixation device);
- 22845 (Insert spine fixation device);
- 22851 (Apply spine prosth device).
ASCA CEO Bill Prentice said, “In addition to our perennial concern that the use of different inflation factors continues the divergence in payments between ASCs and HOPDs for performing the same procedures, we are also disappointed that CMS remains slow to recognize that ASCs can safely perform many more procedures than currently allowed. Adding procedures that ASCs are currently performing with great success on commercial patients to our list of payable procedures would reduce costs for both beneficiaries and the Medicare program.”
CMS also is seeking public comments on whether CPT code 27447 (Total knee arthroplasty) should be removed from the inpatient-only list, the ASCA reports.
The proposed rule was published in the Federal Register on July 15, and the proposal can be accessed online at http://bit.ly/29NT4Em. Readers can submit comments until 5 p.m. EST on Sept. 6, 2016, by going online to http://www.regulations.gov. Readers can follow the instructions listed under the “submit a comment” tab. In commenting on the proposed rule, readers can refer to file code CMS-1656-P.