ASCs lock in higher Medicare, Medicaid payment rate

Editor's Note

Ambulatory Surgery Centers (ASCs) will now receive a 3.1% payment rate from the Centers for Medicare and Medicaid Services (CMS) for services, which is an increase of .3% under the original rule, Becker’s ASC Review December 5 reports.

This change in payment rate reflects the average of all procedures, but individual procedure rates may vary and can be checked using the calculator on the CMS website. While ASC leaders remain concerned that the increase will still not be enough to offset rising medical costs, the Ambulatory Surgery Center Association (ASCA), which helped to secure the increase, noted that it is much more favorable than rates for other providers. Physician fees, for instance, are being cut again this year. 

ACSA also helped to secure an alignment between ASC payment rates and hospital market basket rate for the next 2 years. In addition, a new performance measure for total hips and total knees will become effective in 2028, which will be patient-reported outcome-based–a delay of 1 year from the proposed rule.