Executive Summary of CY 2025 Medicare Updates for ASCs

Gain vital updates with our executive summary on the CY 2025 Medicare updates affecting Ambulatory Surgery Centers (ASCs), primary care physicians, specialists, and medical suppliers. This detailed overview encompasses crucial changes in payment structures, policy enhancements, and quality reporting under the CMS 1924-FC Final Rule, aimed at improving operational efficiency and quality of care in ASCs.

Key Features:

• • • Payment Rate Increase: A 2.9% raise for ASCs adhering to quality reporting standards.

    • ASC Conversion Factor: Introduction of a new conversion factor set at $54.895 for compliant ASCs.

    • Extended Services: Expanded list of procedures eligible for reimbursement, fostering greater efficiency and reduced wait times.

    • Prior Authorization Policy: Streamlined review timeline from 10 to 7 days, simplifying the process for service approval.

    • Quality Reporting Program Updates: Refinements in quality measures and introduction of new patient safety metrics to enhance care outcomes.

    • OPPS Transitional Pass-Through Payment for Devices: Inclusion of innovative devices to support cutting-edge surgical outcomes and efficiency.

    • Non-Opioid Pain Management: CMS's finalized policy to offer separate payments for non-opioid pain treatments in ASCs, promoting safer pain management alternatives.

    • Expanded ASC Coverage: Updates to the Covered Procedures List (CPL) adding 21 new surgical procedures, broadening the scope of services offered to Medicare beneficiaries.