The Centers for Medicare & Medicaid Services (CMS) released the 2015 final payment rule for ASCs and hospital outpatient departments (HOPDs) on Friday. The final rule can be found here: http://associationdatabase.com/aws/CASA/asset_manager/get_file/88319/medicare_2015_final_rule.pdf.
ASC payment rates will increase by 1.4 percent in 2015. This increase is based on a projected rate of inflation of 1.9 percent minus a 0.5 percentage point productivity adjustment required by the Affordable Care Act. This payment update is higher than the 1.2 percent update in the proposed rule, which was based on an inflation rate of 1.7 percent minus a 0.5 percentage point productivity adjustment.
Medicare outpatient payments to hospitals will receive 2.2% in 2015. The 2.2% update for hospitals was calculated from a 2.9% market-basket increase, minus a 0.5% productivity adjustment and a 0.2% cut required by the Patient Protection and Affordable Care Act.
CMS also finalized a significant change to its device-intensive policy that will benefit the ASC community. In its final rule, CMS defines ASC device-intensive procedures as those procedures that are assigned to any ambulatory payment classification (APC) group with a device cost greater than 40 percent of the total cost of the procedure in the HOPD setting. The previous threshold was 50 percent. There are 48 codes with high device costs that ASCs will be able to perform with a more positive fiscal impact.
A positive outcome is eleven new spine procedures are being added to the ASC approved list of procedures for 2015. These new codes are the following:
• 22551 Neck spine fuse&remov bel c2
• 22554 Neck spine fusion
• 22612 Lumbar spine fusion
• 22614 Spine fusion extra segment
• 63020 Neck spine disk surgery
• 63030 Low back disk surgery
• 63042 Laminotomy single lumbar
• 63045 Removal of spinal lamina
• 63047 Removal of spinal lamina
• 63056 Decompress spinal cord
• 63044 Laminotomy additional lumbar
For more information about this topic please contact:
Richard Haskin, Esq., Partner
Gibbs Giden Locher Turner Senet & Wittbrodt LLP
7450 Arroyo Crossing Parkway, Suite 270
Las Vegas, Nevada 89113
Copyright 2014 Gibbs Giden Locher Turner Senet & Wittbrodt LLP