CMS Issues 2018 Opps Rule

National Medical

National Medical

CMS ruled Wednesday, November 1, 2017, on the Hospital Outpatient Prospective Payment System (PDF). The 1,133-page document contains the following key takeaways for ASCs:

3 new procedures added to the ASC covered procedure list-

Cervical Artificial Diskectomy (CPT 22856)
Second Level Cervical Diskectomy (CPT 22858)
Total Laparoscopic Hysterectomy (Uterus over 250g; CPT 58572)

Total Knee Arthroplasty removed from IPO, Inpatient-only list. Further total joint discussion to occur in future rulings.

ASC payment rate increase 1.2%; ASC payment rate now at 1.7%
The originally proposed ASC payment rate increase of 1.9% did not stand.
The rate increase of 1.2% was determined using the following: Affordable Care Act required productivity adjustment of negative 0.5% and 1.7% projected rate of inflation.
ASCs remain on the CPI-U index for inflation.

Hospital Outpatient payment rate increase of 1.35%; HOPD payment rate now at 2.7%

The originally proposed HOPD payment rate increase of 1.75% did not stand.
The rate increase of 1.35% was determined using the following: Affordable Care Act required adjustment of negative 0.75% and productivity adjustment of 0.6% update under similar ACA
cuts, and a 2.7% market basket update.

OAS CAHPS survey mandatory implementation delayed through 2018. ASC’s may participate under voluntary measures.

Quality Measures
Removed: ASC-5: Prophylactic Intravenous Antibiotic Timing; ASC-6: Safe Surgery Checklist Use, and ASC-7: ASC Facility Volume Data on Selected Procedures.
Adopted for CY 2022 payment determination: ASC-17: Hospital Visits after Orthopedic Ambulatory Surgical Center Procedures, and ASC-18: Hospital Visits after Urology Ambulatory Surgical Center Procedures. ASC-16 not adopted as proposed.

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