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Congress Addresses Physician Medicare Payments

Update on ASC Services Designated as Office-based

Congress Addresses Physician Medicare Payments

Update Impacts ASC Services Designated as Office-based

Last night the House approved legislation previously passed by the Senate to eliminate the 21.2 percent cut in payments under the physician fee schedule through November 2010. 

The legislation, which applies retroactively to June 1, will increase rates by 2.2 percent during that period. 

As you know, payments for ASC services designated as office-based are paid the lesser of the physician fee schedule rate or the hospital outpatient PPS rate.

Last Friday, CMS began processing claims for for services after May 31 at the reduced payment rate. 

However, CMS indicated yesterday that the agency will reprocess claims paid at the lower rate if the Congress approved legislation blocking the cut. 

The President is expected to sign the legislation shortly, and ASCs should expect that CMS will  begin paying claims at the revised rate (2.2 percent higher than the rates for January through May). 

CMS indicated that revised rate tables will be posted on the agency's website in approximately two weeks.

We will continue to keep you posted on developments, including how the agency intends to handle the retroactive application of the rates and when ASCs should expect to see their payments adjusted.  We will also circulate the revised rate schedule as soon as it is available.

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