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CMS Proposes Rates, Policies for 2014 Medicare Outpatient and ASC Services

July 19, 2013

 

The Centers for Medicare and Medicaid Services (CMS) has issued its proposed policy changes and payment rates for hospital outpatient departments and ambulatory surgical center services for 2014.

 

Hospital Outpatient

  • The proposed market basket update for 2014 is 1.8 percent.
  • CMS proposed to “package” more ancillary items and services within the outpatient payment categories that they support. These include, among others, drugs, biologicals, and radiopharmaceuticals that function as supplies when used in a diagnostic test or procedure.
  • CMS proposed adding five new measures for the hospital outpatient quality reporting program and removing two existing measures.
  • CMS proposed to streamline the current five levels of outpatient visit codes in an effort to remove incentives to provide additional, unnecessary services.

 

Ambulatory Surgery Centers

  • The market basket update for ASCs is proposed to be 0.9 percent.
  • CMS proposed that the ancillary services that would be packaged under the hospital outpatient payment system for 2014 would also be packaged under the ASC payment system for 2014.
  • CMS proposed to adopt four new measures for the ASC quality reporting program.
  • Payments to ASCs which fail to meet ACO quality reporting requirements would be reduced by 2 percent.

 

Comments on the proposal are due by September 6, 2013.

 

Click to view CMS press release

Click to view proposed regulation