Medicare's 2011 ASC Payments: Rates and Policies
Medicare's 2011 ASC Payments: Rates and Policies
Proposed 2011 Medicare Rates and Payment Policies Released!
On July 2, 2010 the Centers of Medicare and Medicaid Services (CMS) released its proposal for 2011 ASC Medicare payments. It is expected that the proposal will be finalized in November.
Changes in ASC Rates for 2011
The proposal does not provide an an inflationary update in ASC reimbursement rates. The change in the Consumer Price Index for Urban Consumers (CPI-U) is estimated to be +1.6%, however the health reform legislation adopted earlier this year requires a1.6% offset resulting in a 0% proposed update for 2011.
ASC 2011 payment rates will none-the-less be different than the 2010 rates due to several other factors. You will need to review payment changes at the procedure level to determine the impact of the proposed changes on your particular ASC.
Five New Procedures Proposed for 2011
CMS has proposed to add five procedures the list of ASC payable procedures. In addition, CMS has added eight newly created CPT codes to the ASC list beginning July 1, 2010. The proposal would not remove any procedures or codes from the ASC list.
Would you like to see additional procedures added to the list of Medicare covered procedures? Fill out this form and e-mail it to asc@ascassociation.org and we will work to get them added.
No Quality Reporting for 2011
CMS's proposal would not require ASCs to report quality data in 2011. It is expected however that ASCs will be required to report quality data in the future. A great way to prepare is to participate in the ASC Association's Outcomes Monitoring Project.
Preparing Your ASC for the 2011 Changes
A detailed analysis of the proposed 2011 rates will be available shortly. Pre-order yours today!
Don't miss a special webinar, Medicare's 2011 Payments: What Is Being Proposed?, by Kathy Bryant, president of the ASC Association on August 24, 2010 Register today
Not yet an ASC Association Member? JOIN TODAY!
Back to the Medicare Main Page 
Go to the 2010 Medicare Payment Page
Resources from the ASC Association
Download the Proposed 2011 Payment Rule
More resources coming soon!
2011 Proposed Medicare Rate Calculator
This calculator shows your proposed local payment rates for 2011. Simply look up your local wage index from the easy to use chart and type it into the calculator and the calculator does the rest.
2011 Proposed Separately Payable Procedures
This document provides the proposed list of procedures that are payable in an ASC in 2011 and for which there is a separate payment made. The HCPCS code and the proposed 2011 national ASC rate are provided. This list does not include packaged procedures.
2011 Proposed Packaged Procedures
This chart lists the procedures that are proposed to be on the 2011 ASC list, but for which there are no separate payments because payments for these packaged procedures are included in the payments made for other procedures.
2011 Proposed ASC List Additions
This chart shows the proposed ASC list additions. Their HCPCS code and their 2011 proposed national ASC payment rate are provided.
2011 Proposed Ancillary Services
This chart provides the proposed list of covered ancillary services for 2011. ASCs may bill for ancillary services when provided in conjunction with covered surgical procedures.
2011 Proposed Device Intensive Procedures
This chart lists the procedures proposed to be classified as device intensive in 2011 and the proposed 2011 ASC payment rate.
2011 Proposed Office Based Procedures
This chart lists the procedures proposed to be classified as office based for 2011, their proposed 2011 payment rates, and whether the rates are based on the hospital outpatient department rates or on the physician's practice expense rates.
2011 Proposed Multiple-Procedure Discounting Exempt
This document lists the procedures that are proposed to be exempt from multiple-procedure discounting in 2011.
2011 Proposed NTIOLs
Medicare provides an additional $50 payment for certain NTIOLs. The following chart provides information on the lenses proposed to eligible for an additional $50 payment from Medicare in 2011.
2011 Proposed Coinsurance and Deductable Waived Services
This chart provides the services for which the patient deductable and coinsurance is proposed to be waived in 2011.
