ASCs see 1.4% fee increase, addition of 11 spine codes to payment list

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Note:  The following article synopsis was NOT provided by HCPro. It was created by Find-A-Code/innoviHealth.

Article Overview

This piece explains changes in the 2015 Medicare outpatient hospital and ambulatory surgery center payment rule as it relates to ASC facility reimbursement and spine procedures newly eligible for payment in the ASC setting. It is relevant for ASC administrators, coders, and revenue cycle staff tracking Medicare payment policy, ASC coverage updates, and code-list changes tied to facility fee billing.

Why This Topic Matters

ASC payment-list changes and annual fee updates can affect whether procedures are payable in the ambulatory surgery center setting and influence facility revenue planning. Readers who manage outpatient surgical coding or reimbursement need to know which procedure categories were added and how the annual payment adjustment compares with other outpatient settings.

Article Sections

  1. Surgery centers

    Introduces the 2015 Medicare ASC payment update and the addition of spine procedures to the ASC payment list. Also notes the policy background for the change.

  2. The newly included codes and facility payments are:

    Presents the list of newly covered spine procedure codes and the associated ASC facility payment information.

  3. ASC fees get a 1.4% payment boost next year

    Summarizes the annual ASC payment update and compares it with the hospital outpatient department increase.

What You Will Learn

  • How the 2015 Medicare ASC payment rule affected facility-fee billing
  • Which broad categories of spine procedures were added to the ASC payment list
  • How the ASC annual payment update compares with the hospital outpatient department update
  • What policy source is cited for the payment change

Who Should Read This

  • Ambulatory surgery center administrators
  • Medical coders
  • Billing and reimbursement staff
  • Revenue cycle professionals
  • Healthcare compliance teams

Codes Discussed


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