2009 Final ASC Payments: Policies and Rates
Under Medicare's payment system ASCs are paid a facility fee intended to cover the costs associated with providing surgical procedures. However, in general, ASCs are only paid a portion of what HOPDs receive for the exact same services. For 2008 ASCs were paid only 63% of what HOPDs received for providing the exact same services. For 2009, it is estimated that ASC reimbursement will only be 59% of HOPD reimbursement for the same services.
On October 30, 2008, Medicare released its final payment policies and rates for 2009. In general, ASCs will continue to be paid in much the same way as they are currently. The finalized payment policy adds 27 procedures to the ASC list of payable procedures.
A detailed analysis of the 2009 rates is available from the ASC Association. Order yours today!
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Resources from the ASC Association:
2009 Final Payment Policies and Rates
2009 Final Medicare Payment Rule
Download the final 2009 payment rule here. The section on the 2009 Medicare payments begins on p. 222.
Order the ASC Association's 2009 Medicare Rate Analysis
This publication compares by specialty and at the CPT code level 2009 payments for ASCs to 2008 reimbursement and to hospital outpatient department reimbursement for the same procedure.
2009 Medicare Rate Calculator
Calculate your 2009 local payment rates! This calculator allows you to insert your ASC wage index for 2009 and see the national payment rates, local payment rates, amount Medicare pays and the beneficiary co-payment amounts for each surgical procedure payable in 2009.
2009 ASC List of Payable Procedures
This document contains the list of payable procedures effective January 1, 2009, and corresponding national payment rate.
2009 ASC List Additions
This file includes information about the 27 procedures added for 2009 — CPT code, a short description and the national ASC payment rate are provided.
2009 ASC List Deletions
This file includes information about the 21 procedures deleted from the ASC list for 2009 — HCPCS code, a short description and the 2008 national ASC payment rate are provided.
2009 Device Intensive Procedures
This chart lists the procedures classified as device intensive in 2009 and the 2009 ASC payment rate. The chart also includes whether or not they are classified as device intensive for the first time.
2009 Office Based Procedures
This chart lists the procedures classified as office based in 2009, their 2009 payments rate and whether the rates are based on the hospital outpatient department weights or on the physician's practice expense portion.
2009 Ancillary Services Rates
This chart includes the list of covered ancillary services integral to covered surgical procedures for 2009 including ancillary services for which payment is packaged. This document will be updated quarterly to reflect scheduled quarterly updates from Medicare.
2009 Procedures Not Subject to Multiple Procedures Discount
This document includes the list of procedures that are exempt from multiple-procedure discounting in 2009.
2009 ASC List Procedures with No Payment Due to Packaging
This chart lists the procedures that are on the 2009 ASC list but for which there is no separate payment because they are packaged with other procedures.
Procedures Removed from the Inpatient Only List for 2009
This chart shows the procedures removed from the inpatient only list for 2009. The HCPCS code and a short description are provided.
2009 New Technology Intraocular Lens (NTIOL) Payment
Medicare provides an additional $50 payment for certain NTIOLs. The following chart provides information on the lenses eligible for an additional $50 payment from Medicare.
