For the first time in eight years, the list of Medicare-reimbursable procedures at ambulatory surgery centers is expanding, but the number of new codes falls short of centers' expectations.
Changes proposed by CMS, subject to a comment period before the effective date of July 1, would add 288 CPT codes and subtract 141 codes, for a net increase of 147 codes.
That would raise the total of Medicare-reimbursable codes for ASCs to about 2,400, according to statistics from American Association of Ambulatory Surgery Centers.
But AAASC officials say Medicare still won't pay for more than 100 relatively common ASC procedures, forcing Medicare beneficiaries to have those procedures done in hospital outpatient departments.
"We're very, very disappointed," says AAASC lobbyist Mike Romansky.
He adds that even with the new codes, "none of the changes will make or break a facility."
Romansky says 48 of the added codes are at the highest Medicare reimbursement level for ASCs, which is $1,339, subject to regional adjustments, but the additions do not include any of the highest-utilized ASC codes.
He adds that the deleted codes are generally for lower-reimbursed procedures that can be done in a doctor's office.
Romansky says ASCs will have a chance to comment on the CMS proposal during the next three months, but it is unlikely that CMS will make any changes before implementation.