CMS Releases 2025 Updates for Hospital Outpatient & Ambulatory Surgery Center Payment & Policies
On July 10th, the Centers for Medicare and Medicaid Services (CMS) released its calendar year (CY) 2025 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgery Center (ASC) Payment System proposed rule.
As is customary, CMS also revises the OPPS and the ASC payment system and updates requirements for the Hospital Outpatient Quality Reporting (OQR) Program and the ASC Quality Reporting (ASCQR) Program.
Increase to Hospital Outpatient Payments. Because federal statute includes an inflationary update for facility payments, CMS proposes a conversion factor of $89.379 under the OPPS. If finalized as proposed, this will result in an increase of hospital outpatient payments by about 2.6% or roughly $5.2 billion over 2024.
ASC Covered Procedure List (ASC CPL): As is required by statute, CMS evaluates its list of procedures that can be safely performed in an ASC. In advance of CY 2025 rulemaking, the Ambulatory Surgery Center Association (ASCA) included cardiac ablations on its list of services to be added to the ASC CPL. HRS advocated for CMS to address these recommendations in the CY 2025 OPPS/ASC proposed rule. However, CMS neither proposes to add cardiac ablations to the ASC CPL nor does it even include that the recommendation was submitted.
HRS is planning to submit comments prior to the September 9th deadline. In these comments, HRS will weigh in on the addition of cardiac ablations to the ASC CPL as well as express concern over the lack of transparency and failure to solicit additional input on the recommendation to add cardiac ablations to the ASC CPL.