Ask Caryl: Medicare 2021 Final ASC Payment Rule
Q: How does Medicare’s 2021 final payment rule for ASCs affect my revenue cycle?
Caryl Serbin: As the Ambulatory Surgery Center Association (ASCA) notes, there are several significant changes for ASCs in Medicare’s 2021 final payment rule. Only a few that will affect your revenue cycle tasks:
CMS finalized the addition of 267 codes to the ASC Covered Procedures List (ASC-CPL). A particularly noteworthy addition is total hip arthroplasty (CPT 27130.
CMS approved an average rate update of 2.4% across all covered procedures. This will vary by procedure code and specialty.
CMS finalized its decision to revise ASC-CPL criteria. This results in 250-plus additional codes added to the ASC-CPL.
These changes went into effect on Jan. 1, 2021.
To learn more about the final rule, I recommend that you read the ASC Focus article, “Takeaways From Medicare’s 2021 Final Payment Rule.” This article includes additional helpful resources, such as a link to ASCA's ASC rate calculator that members can use to determine what they will be paid locally.
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