ASCs Will Benefit from New Payment Rates for 2012
AGA has reviewed the final rule for payments to ambulatory surgery centers (ASCs) and hospital outpatient departments (HOPDs) for 2012 and prepared an in-depth analysis of the impact to GI.
Payments to ASCs will increase by 1.6 percent, and payment rates under the outpatient protective payment system will increase by 1.9 percent, effective Jan. 1, 2012. Review AGA’s payment analysis for GI codes paid under the ASC and the HOPD systems.
CMS finalized the recommendation of AGA, ASGE and ACG to create a new upper level gastroenterology procedure ambulatory payment classification (APC) code (0419). This new APC level will allow for more equitable payment across gastroenterology procedures and enables procedures to be placed into groups that will more accurately reflect shared clinical and resource homogeneity. CMS also increased payments for APC 0422 (level III upper GI procedures). By establishing the new APC and increasing payments for APC 0422, facilities will be able to cover costs, and patients will have access to important and lifesaving procedures.
AGA has also prepared a detailed summary of the rule. Important for GIs is a new quality reporting program for ASCs. The final rule adopts five quality measures, including four outcome measures and one surgical infection control measure beginning in calendar year (CY) 2012 for the CY 2014 payment determination.
The final rule will appear in the Nov. 30, 2011, Federal Register.
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