Part B Insider (Multispecialty) Coding Alert

Published on Sat Dec 09, 2006 PDF

If your physician owns or runs an ambulatory surgery center (ASC) you could soon have a new payment system to contend with, thanks to a new report from the Government Accountability Office (GAO) (GAO-07-86).

Congress asked the GAO to study the differences between payments in the hospital outpatient department and the ASC setting. The GAO found that the outpatient payments accurately reflected the costs of the same procedures in ASCs.

If anything, the cost of performing surgeries in the ASC setting is -substantially lower- than in the outpatient departments, the GAO found. The GAO recommends that Medicare pay for ASC procedures based on the hospital outpatient prospective payment system (HOPPS). The Centers for Medicare & Medicaid Services said this recommendation was in line with its own proposals from August 2006.