We view this rule as another positive sign that CMS is paying careful attention to the results that ASCs are having on controlling Medicare costs without diminishing quality or safety, and we remain optimistic about our working relationship with CMS going forward. We were pleased to see that CMS is proposing to continue to align the ASC update factor with the factor used to update HOPD payments. Under this proposal, CMS will continue to use the hospital market basket to update ASC payments for calendar year (CY) 2020 through CY 2023 as it assesses the impact on volume migration.
As a result, if the rule is finalized as written, ASCs will see, on average over all covered procedures, an effective update of 2.7 percent—a combination of a 3.2 percent inflation update based on the hospital market basket and a productivity reduction of .5 percent mandated by the Affordable Care Act.
It is important to remember that the 2.7 percent increase is an average that will not apply equally to every procedure ASCs perform, so updates might vary significantly by code and specialty. Also, this proposed update does not take into consideration sequestration, which reduces ASC payments by 2 percent each year until at least 2024 unless Congress acts.
ASCA has updated its Medicare rate calculator so members of the association can see what payments they would receive if the rates were to be finalized as proposed. There are always significant changes to most of the rates between the proposed and final rules, however, so we are also advising members who use the calculator to make sure to download the rate calculator once the rule is finalized in November to see the actual payments their facility will receive.