Special Report: Long-awaited new ASC codes finally revealed

Why This Topic Matters

ASC code-list updates can change which procedures qualify for facility billing and can influence Medicare reimbursement patterns. The article is useful for organizations that need to monitor ASC eligibility, reimbursement policy timing, and payer contract implications.

Article Sections

1. ASC code list update

   Overview of the CMS update to the ASC-approved procedure list and the timing of the change. The section frames the scope of additions and deletions discussed in the article.

2. Prospective payment structure still delayed

   Discussion of the delayed ASC payment-structure transition and the factors affecting CMS implementation timing. This section addresses the broader policy context surrounding the code list update.

3. Most often billed ASC procedures not paid as of July 1

   A table of commonly billed ASC procedures that are not included in payment beginning on the stated effective date. The section presents utilization and payment context for affected procedures.

4. Most frequently billed outpatient hospital procedures added to Medicare ASC list

   A table of outpatient hospital procedures that were added to the Medicare ASC list. The section shows procedure-volume context and the associated ASC facility payment categories.