Ambulatory Surgical Center (ASC) Payment

Spotlights

ASC Covered Procedures List (CPL) Nomination Process for CY 2023

  • Information related to this process is now available.
  • For questions, concerns, suggestions, or inquiries regarding the ASC CPL, please consider contacting CMS by email at ASCPPS@cms.hhs.gov

Ambulatory Surgical Center Rulemaking

CMS issued the CY 2022 OPPS/ASC final rule and related files  that update Medicare payment rates, quality reporting programs, and policies. See a summary of key provisions, effective January 1, 2022:

  • Price Transparency of Hospital Standard Charges
  • Beneficiary Protections
  • Health Equity, Access to Emergency Care in Rural Areas, & Lessons from COVID-19
     

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 submits a report to Congress containing this plan.

The Report to Congress (PDF) 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).

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.

ASC CENTER

For a one-stop resource for Medicare Fee-for-Service (FFS) ambulatory surgical centers, visit the Ambulatory Surgical Centers (ASC) Center page.

Page Last Modified:
01/06/2022 04:57 PM