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OMB reviews new ASC payment system, CfC criteria

Ambulatory Surgery Reimbursement Update, June 12, 2007

The White House Office of Management and Business (OMB) is presently reviewing rules covering the new ASC payment system, along with revisions to Medicare's conditions for coverage (CfC) for ASCs, according to the FASA Web site.

The new payment system, as proposed by CMS, will be based on hospital outpatient department rates and the ambulatory payment classification (APC) system. FASA expects final ASC rates for 2008 to be released in November 2007.

The OMB is also evaluating CfC, which are the criteria ASCs must meet to participate in the Medicare program and receive reimbursement. There are currently ten general criteria ASCs must meet, including:

  • Compliance with state licensure law
  • Evaluation of quality
  • Medical records
  • Environment
  • Surgical services

FASA expects the rule for CfC to be released in August 2008.

To view the FASA news brief, click here.

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