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ASCs in the news: 2009 OPPS/ASC final rule has mixed results for ASCs

Ambulatory Surgery Reimbursement Update, November 11, 2008

Less restrictive conditions for coverage (CfC) for ASCs, 27 new payable procedures, but a reimbursement rate lowered to 59% of hospital outpatient department (HOPD) rates are among the principal features of interest to ASCs in the calendar year (CY) 2009 OPPS/ASC final rule, released October 30 by CMS.

The CfCs are less restrictive than a revision CMS proposed last year, according to a news release on the Web site of the ASC Association. The new CfCs reflect current ASC practice by focusing on the care provided to patients and the effect of that care on patient outcomes.

In the final rule (p. 855), CMS now defines an ASC as “any distinct entity that operates exclusively for the purpose of providing surgical services to patients not requiring hospitalization and in which the expected duration of services would not exceed 24 hours following an admission.”

For more information, go to the CMS Web site. The 2009 OPPS/ASC final rule will appear in the November 18 Federal Register.

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