Navigating Changes in the CMS 2024 Proposed Payment Rule for ASCs

Here’s what to expect on this week’s episode. 🎙️

The CMS 2024 Proposed Payment Rule was officially released a few weeks ago. The 963-page document outlines the potential changes CMS is considering for 2024, and stakeholders have 60 days to respond and comment on the proposal. Once finalized, the rule will become official and will guide how Medicare and Medicaid operate in 2024. Here are a few highlights:

💰 On average, surgery centers would see an effective update of 2.8% over all covered procedures. For some procedures, including cataracts, GI, and pain, the payment update is closer to 5.5% (variations will occur).

🔢 ASC Quality Reporting Program
• ASC-7: ASC Facility Volume Data – voluntary collection will start in 2025 and mandatory collection in 2026.
• ASC-9: Endoscopy/Polyp Surveillance – will be modified by changing the denominator from 50 to 45 years old.
• ASC-11: Cataracts Visual Functions – will remain voluntary.
• ASC-20: COVID-19 Vaccination Coverage Among Health Care Personnel – will continue to be required.
• ASC-21: Risk-Standardized Patient-Reported Outcome-Based Performance Measure (PRO-PM) – will be a new measure.

😡 Despite several requests from ASCs and ASCA, CMS has added only one of the sixty-three requested codes, G0330 Dental Rehabilitation, to the Covered Procedures List.

🗣 All members of the surgery center industry are strongly encouraged to submit feedback to the Centers for Medicare & Medicaid Services by September 11, 2023, to help shape future policies that will affect the industry directly.

Thank you to Maura Cash, William Prentice, Kara Newbury, and the Ambulatory Surgery Center Association for their industry expertise and guidance!

Submit comments to CMS: https://www.regulations.gov/document/CMS-2023-0120-0002

Find the full episode on Apple Podcasts, Spotify, or YouTube to hear all the details.