2017 Medicare outpatient and ASC payment changes

November 7, 2016

A wide range of Medicare payment and policy changes will go into effect for hospital outpatient departments and ambulatory surgical centers in 2017, according to a final rule issued by the Centers for Medicare & Medicaid Services (CMS): 

 

  • Payment: Hospital outpatient department payments will rise 1.7% in 2017.  Those for ambulatory surgical centers (ASCs) will rise 1.9%.

 

  • Site Neutral Payments:  Hospital outpatient departments that acquire off-campus physician practices will face new payment rules.  For 2017 and 2018, Medicare will pay for care in such facilities at half the hospital outpatient rate.  The agency granted exceptions, however, if the facility:
    • Is within 250 yards of a hospital or a remote location of a hospital;
    • Is a dedicated emergency department; or
    • Billed for care furnished prior to November 2, 2015.

 

  • Imaging APCs:  Current imaging APCs under the hospital outpatient payment system will be consolidated from 17 to 7.  CMS said its intent was to improve the clinical and resource homogeneity of the services classified within the imaging APCs.  

 

  • Film X-Ray:  Medicare payment for the technical component (TC) of film X-Ray services will be reduced by 20% beginning January, 2017.

 

  • Quality Reporting: CMS is adding new measures for hospital outpatient department and ASC quality reporting.