News | November 08, 2007

CMS Releases Final ASC Payment Rates for 2008

November 10, 2007 - The Centers for Medicare and Medicaid Services (CMS) recently released its final rule establishing the ASC payment rates that will apply to services provided in 2008. This rule finalizes the ASC payment rates for ASCs and HOPDs proposed in August 2007. It also establishes the first payments determined using the new ASC Medicare payment system CMS finalized in August.

In 2008, ASCs will generally be paid 65 percent of the HOPD payments as was proposed in August. Although the percentage is the same, the actual payment rates will vary from those proposed in August because the relative weights used differ from those proposed.

Under the final rule, 3,390 procedures will be payable in the ASC setting in 2008, an increase of 819 over the number currently payable in ASCs. FASA and its members have been saying that some of these procedures, like laparoscopic cholecystectomies, should have been included on the list even under the old criteria.

Although ASCs were unsuccessful in convincing CMS to add these and many other procedures under the old criteria, the new process and the new criteria resulted in their addition to the list. A complete list of additions and deletions will be uploaded to FASA’s web site shortly.

As FASA reported previously, the ASC payment rates under the new ASC payment system will be transitioned into use over a four-year period for procedures currently on the ASC list, a process that will give individual ASCs more time to adjust to the new payment system than an immediate transition to the full system would have provided. Newly added procedures will transition to the full payments established under the new ASC payment system immediately. The national 2008 ASC rates and what the rates would be if fully transitioned in 2008 will be available shortly on FASA’s web site. A special rate calculator that can be used to determine your local payments will also be available on FASA’s web site soon.

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