The Centers for Medicare & Medicaid Services recently released its 2017 ambulatory surgery center (ASC) payment final rule.

There were a few changes worth noting, according to the national ASC Association (ASCA).

1. Payment increase. ASC payment rates will increase by 1.9%, which is larger than the 1.2% identified in the proposed rule.

2. Procedures added. Ten new procedures were added to the ASC list of payable procedures for 2017. They are as follows:

  • 20936 (Sp bone agrft local add-on)
  • 20937 (Sp bone agrft morsel add-on)
  • 20938 (Sp bone agrft struct add-on)
  • 22552 (Addl neck spine fusion)
  • 22840 (Insert spine fixation device)
  • 22842 (Insert spine fixation device)
  • 22851 (Apply spine prosth device)
  • 22853 (Insertion of interbody biomechanical device(s))
  • 22854 (Insertion of intervertebral biomechanical device(s))
  • 22859 (Insertion of intervertebral biomechanical device(s))

Unfortunately, as ASCA notes, “… these codes are add-on codes, and thus will not be separately payable when performed in the ASC.”

3. Comments sought on total knee arthroplasty. CMS has requested public comments on whether CPT code 27447 (total knee arthroplasty) should be removed from the inpatient-only list. ASCA noted it has advocated for the code’s removal from the inpatient-only list and will continue to do so.

4. Measures added. Seven new measures will be added for 2020 payment determinations. They are as follows:

  • ASC-13: Normothermia Outcome
  • ASC-14: Unplanned Anterior Vitrectomy
  • ASC-15a: OAS CAHPS – About Facilities and Staff
  • ASC- 15b: OAS CAHPS – Communication About Procedure
  • ASC-15c: OAS CAHPS – Preparation for Discharge and Recovery
  • ASC-15d: OAS CAHPS – Overall Rating of Facility
  • ASC-15e: OAS CAHPS – Recommendation of Facility

In December, ASCA will host a webinar on “Understanding Medicare’s 2017 Final Payment Rule.” For more details, click here.