Potential Impacts On July 15, 2025, the CMS released the proposed rule for the OPPS and ASC Payment System for calendar year 2026. This article provides an update on the proposed OPPS changes. On July 15, 2025, the Centers for Medicare & Medicaid Services (CMS) released the proposed rule for the Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System for calendar year (CY) 2026. Among other items, the agency proposes increasing payments to all outpatient providers, eliminating the Inpatient Only (IPO) List, and changing quality reporting programs. For most procedures, the payment rates under the OPPS…
-
-
Reimbursement (Part III of V) As noted in the first installment of this five-part series, an ambulatory surgery center (ASC) is a distinct entity that primarily provides outpatient surgical procedures to patients who do not require an overnight stay after the procedure. The facilities typically provide relatively uncomplicated surgical procedures in a non-hospital, outpatient setting, and most ASC cases are non-emergency, noninfected, and elective. This third installment on the valuation of ASCs will discuss the reimbursement environment of ASCs. [su_pullquote align=”right”]Resources: Valuation of Ambulatory Surgery Centers—Introduction (Part I of V) Valuation of Ambulatory Surgery Centers—Competition (Part II of V) [/su_pullquote]…