Ambulatory Surgical Center (ASC) Payment
Notice: CMS will make corrections to the CY 2012 ASC payment rates and status indicators issued in the CY 2012 OPPS/ASC final rule with comment period (CMS-1525-FC), published in the Federal Register on November 30, 2011, in an upcoming correction notice. To view the revised ASC payment rates that result from the revised ASC relative payment weights, see the ASC Addenda that are posted on the CMS Web site at: http://www.cms.gov/ASCPayment/ASCRN. Select “CMS-1525-FC” from the list of regulations. All revised ASC addenda for this correction notice are contained in the zipped folder entitled “Addendum AA, BB, DD1, DD2, EE” at the bottom of the page for CMS-1525-FC).
Separately, the CMS January 2012 addenda AA and BB have been further updated to reflect the revised payment rates based on changes to the Medicare Physician Fee Schedule created by the temporary extension of health provisions legislation. The January 2012 ASC Approved HCPCS Code and Payment Rates addenda have been posted and are accessible on the CMS website at: http://www.cms.gov/ASCPayment/11_Addenda_Updates.asp#TopOfPage
Value Based Purchasing Program for Ambulatory Surgical Centers
The Affordable Care Act requires the Secretary of Health and Human Services to develop a plan to implement a value-based purchasing (VBP) program for payments under the Medicare program for ambulatory surgical centers (ASCs). The Secretary shall submit the report containing this plan to Congress.
The Report to Congress describes the current efforts to improve quality and payment efficiency in ASCs. In addition, it considers the steps required in designing and implementing an ASC VBP program for payments under the Medicare program. CMS views VBP as an important step forward in revamping how Medicare pays for health care services; moving the program towards rewarding better value, outcomes, and innovations, instead of merely volume.
The ASC VBP Report to Congress was authorized under Section 3006(f) of the Patient Protection and Affordable Care Act (Pub. L. 111-148), enacted on March 23, 2010, as amended by the Health Care and Education Reconciliation Act of 2010 (Pub. L. 111-152), enacted on March 30, 2010 (collectively known as the Affordable Care Act) (as added by section 10301(a) of the Affordable Care Act).
See the Report to Congress in the Downloads section below.
Ambulatory Surgical Center (ASC) Approved HCPCS Codes and Payment Rates
These files contain the procedure codes which may be performed in an ASC under the Medicare program as well as the ASC payment group assigned to each of the procedure codes. The ASC payment group determines the amount that Medicare pays for facility services furnished in connection with a covered procedure. For 2000 - 2006 files, go to the ASC Payment Rates Archive page (see the Left column).
Note: These files contain material copyrighted by the American Medical Association.
For a one-stop resource web page focused on the informational needs and interests of Medicare Fee-for-Service (FFS) ambulatory surgical centers, go to the Ambulatory Surgical Centers (ASC) Center (see under "Related Links Inside CMS" below).
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