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What Ambulatory Surgery Centers Need To Know for 2022

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Each year, the Center for Medicare and Medicaid Services (CMS) updates and publishes new rulings for the following year regarding services rates and updated or newly implemented regulations. The final rulings for 2022 for Ambulatory Surgery Centers (ASCs) were released in early November of 2021. Here’s a breakdown of the key takeaways ASCs need to know throughout 2022.

Changes to ASC Payment Rates and Quality Measures

In 2022, CMS updated ASC payment rates by two percent for centers that meet the quality reporting requirements. This update to the payment system rate will span a period of five years per the CY2019 ASC rule. Additionally, the CMS will be adopting and implementing a COVID-19 vaccination measure for health care personnel.

Rate Setting Adjustments Given the Pandemic

Due to the Public Health Emergency (PHE), and the number of Covid-19 related factors over the course of 2020, the data does not represent the best approximation of expected services. CMS has used CY2019 data to set the ASC payment system rates for CY2022.

Changes and Additions to ASC Covered Procedures

CMS will be reinstating the criteria for adding procedures to the ASC covered procedures list as it was in 2020. Three procedures that were proposed for removal from the covered procedure list will be retained:

  • 0499T: Cystourethroscopy, with mechanical dilation and urethral therapeutic drug delivery for urethral stricture or stenosis, including fluoroscopy, when performed
  • 54650: Orchiopexy, abdominal approach, for intra-abdominal testis
  • 60512: Parathyroid auto transplantation

In addition, beginning this month, external parties that are familiar with procedures within their given specialty will be allowed to nominate procedures to be included on the ASC covered procedures list. After review, if CMS comes to an agreement, it will be included in the final ruling that goes into effect January 1, 2023.

Inpatient Only List Sticks Around

Although many may be surprised by the decision, CMS has ruled to keep the Medicare Inpatient Only List (IPO). Most recently in 2021, CMS proposed to eliminate the IPO list to its entirety by 2024, however, they have reversed the list change. Many services previously removed last year, are included in the 2022 list and went into effect January 1.


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