CMS Proposes Policy and Payment Changes for Ambulatory Surgery Center (ACS) and Hospital Outpatient Services

The Centers for Medicare & Medicaid Services (CMS) today issued a final rule revising the payment system for services furnished to people with Medicare in ambulatory surgical centers (ASCs) to better align payments for similar services furnished in a hospital outpatient department (HOPD) or a physician's office. CMS also issued a proposed rule that would update Medicare payment for services in HOPDs under the Outpatient Prospective Payment System (OPPS) and would set new payment rates for ASCs under the revised system effective for services in calendar year (CY) 2008. The ASC final rule expands beneficiary access to surgical procedures in ASCs and implements steps to make ASC payments more accurate, while aligning payments across Medicare's payment systems to encourage efficient and appropriate choices of outpatient settings for ambulatory surgical procedures. CMS expects to make payments of almost $3 billion in CY 2008 to the approximately 4,600 ASCs that participate in Medicare.

Comments on the proposed rule will be accepted until September 14, and a final OPPS/ASC payment rule will be published later this fall. For the text of the ASC final revised payment system rule see www.cms.hhs.gov/ASCPayment/

For the text of the combined OPPS/ASC proposed rule, see:
www.cms.hhs.gov/HospitalOutpatientPPS/HORD/list.asp#TopOfPage
For Fact Sheets on the final ASC rule and the combined OPPS/ASC proposed rule, see:
www.cms.hhs.gov/apps/media/fact_sheets.asp