Stethoscope And Dollar

Recent Trends in Medicare Reimbursement

Here are some recent Medicare trends in Ambulatory Surgery Centers across the country:


1. Medicare is adding more procedures

  • Increase in procedures means more options for increasing volume at surgery centers; particularly for Orthopedics and Spine
  • In addition, there have been positive talks with the Ambulatory Surgery Center Association (ASCA) for adding joints in the near future


2. Medicare is looking into Joint procedures successful with commercial payors

  • The positive payback of Joint procedures on non-Medicare patients puts the topic higher on Medicare’s list to discuss


3. Medicare’s fee schedule increase remains flat

  • ASCs will not necessarily see revenue increases from Medicare changes alone, but with the submitting of clean claims, you can enhance Medicare reimbursements though


4. Medicare adds codes to accommodate high-cost supplies

  • Including J codes (drugs and pharmaceuticals), Q codes (grafts), and P codes
  • This shows the flexibility Medicare is adapting that positively effects Ambulatory Surgery Centers


5. Medicare is reimbursing more device-intensive procedures , Which began when transitioning to APC model

  • This continues to enhance accountability for high cost of surgeries, such as:

                                              i.      Cardio Stimulator and Pacemaker procedures

                                             ii.      Urology procedures

                                             iii.      Neurostimulator –related spine and pain management procedures

                                            iv.      Some ophthalmic and ENT device-intensive procedures


Will Mdeicare’s “flexibility” continue to help Ambulatory Surgery Center’s throughout the next couple of years?


The entire article can be read here.


Andréa Venezio , Chief Executive Officer
(972) 232-7700 |

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