Category: ASC Coding, Billing and Collections

 Hudson, Ohio-based physician Deepak Raheja, MD, was sentenced to prison and must pay $2.2 million after pleading guilty to his role in a pharmaceutical kickback scheme, the U.S. Justice Department said Feb. 3.  

UnitedHealthcare made changes to its outpatient procedure group mapping that went into effect Jan. 1.

CMS updated ASC payment rates to 3.8 percent, the most critical reimbursement shift in 2022, according to VMG Health’s “ASCs in 2022: A Year in Review” report released Jan. 26.

The top ASC procedure makes up 20.4 percent of total Medicare payments in 2022, according to a Jan. 26 report from VMG Health. 

The Blue Cross Blue Shield Association released a policy statement backing site-neutral payments as a key focus for saving billions of dollars in the next decade.

CMS will reimburse ASCs for four new procedures in 2023, according to a Jan. 23 report from VMG Health. 

Medicare payments for the top 10 CPT codes are projected to increase by 3.9 percent in total in 2023, according to a Jan. 23 report from VMG Health. 

ASCs are the fourth most common location for No Surprises Act disputes that occurred between April 15 and Sept. 30, according to CMS’ initial report on the independent dispute resolution process. 

Here are three updates about value-based care that ASCs need to know:

Contract disputes and payer splits are threatening coverage nationwide, and some ASCs are being affected by the parties unable to meet year-end or looming deadlines.