CMS finalized a 3.1% payment rate for ASCs in its 2024 final rule, an increase of .3% from the original rule.
Bill Prentice, CEO of the Ambulatory Surgery Center Association, and Kara Newbury, the organization’s director of government affairs and regulatory counsel, laid out what this means for ASCs in an episode of its “Advancing Surgical Care” podcast, released Nov. 15.
While many ASC leaders are concerned the rate does not equate to rising costs, Ms. Newbury noted that the rise in ASCs’ payment rate is higher than other providers.
“We recognize that all of your costs are rising at a higher rate than that, and I hate to say it’s better than the alternative if you look at what’s happening to some of the other payment systems — the Medicare physician fee schedule for instance. They’re seeing another cut this year,” she said.
“We did very, very well relative to a lot of other provider groups in terms of our Medicare rate,” Mr. Prentice added.
The 3.1% update is an average of all procedures, Ms. Newbury said, so ASCs should check specific rates for procedures using the calculator on the organization’s website.
Additionally, ASCs’ payment rates will continue to be updated on the hospital market basket rate for the next two years. ASCA successfully advocated for the alignment, Ms. Newbury said, and were able to get the two year extension.
Additionally, there is a new patient-reported outcome-based performance measure for total hips and total knees that will go into effect for 2028, the podcast added, a one-year delay from the proposed rule.