Physicians will be paid considerably less for lithotripsy procedures performed on Medicare patients this year than was first thought, according to the Ambulatory Surgery Center Association (ASCA).
The national membership association reported on their website May 3 that the November 2011 payment rate for CPT® code 50590 Fragmenting of kidney stones was incorrect. Upon detecting the error, the Centers for Medicare & Medicaid Services (CMS) corrected the payment rate, resulting in a nearly 21 percent payment reduction for the procedure.
The November 2011 payment rate for 50590 was set at a national average of $2,102.29. The adjusted national average, effective Jan. 1, 2012, is $1,665.59, a reduction of $436.70.
According to ASCA, Medicare contractors are not supposed to automatically reprocess claims that have been paid at the incorrect amount.
Source: ASCA, Latest News, May 2012, “Medicare Reduces Lithotripsy Payment Rate“
May 11th, 2012
The Centers for Medicare & Medicaid Services (CMS) announced in a final rule issued Nov. 1 that Medicare payments in 2012 will increase by 1.9 percent to hospital outpatient departments (HOPDs) and 1.6 percent to ambulatory surgery centers (ASCs).
In addition to establishing 2012 payment rates for HOPDs and ASCs, the final rule with comment period:
- Expands the measures to be reported under the Hospital Outpatient Quality Reporting Program
- Creates a new quality reporting program for ASCs
- Addresses Hospital Value-based Purchasing (Hospital VBP) program requirements
- Establishes an electronic reporting pilot that will allow additional hospitals, including critical access hospitals (CAHs), to report clinical quality measures in 2012 for the purpose of participating in the Medicare Electronic Health Record Incentive Program
- Provides a payment adjustment for designated cancer hospitals
November 14th, 2011
The Ambulatory Surgery Center Association (ASCA) — a membership and advocacy organization for ASCs — will no longer manage eight state ASC groups, reports Outpatient Surgery Magazine in its May online edition. Although an official statement has not yet been made by the association, “Sources are calling it a business decision made at ASCA’s annual meeting in Anaheim, Calif., [held May 19-22],” according to Outpatient Surgery Magazine Editor-in-Chief Dan O’Connor.
May 28th, 2010