HRS and ACC Advocate to CMS for Coverage of Ablation Services in the ASC
On August 7, 2024, the Heart Rhythm Society (HRS) and the American College of Cardiology (ACC) met with the Centers for Medicare & Medicaid Services (CMS) Hospital and Ambulatory Policy Group to discuss the societies’ perspective on coverage of catheter ablation procedures performed in the ambulatory surgery center (ASC) setting.
The CMS meeting comes on the heels of a joint society letter sent to CMS in May urging the agency to include ablation procedures in the ASC proposed rule for public comment. CMS did not include ablation procedures in the proposed rule.
The discussion, led by HRS president Dr. Ken Ellenbogen, focused on the safety of ablations supported by a recent large multi-center safety and feasibility study of more than 4,000 EP services performed in ASCs during the COVID-19 pandemic under the CMS Hospital Without Walls program. CMS outpatient claims data were also presented to CMS comparing the safety of ablation with other cardiovascular services performed in the outpatient facility that are currently on the ASC covered procedures list (CPL) and results from the HRS survey of current clinical practices for same-day discharge and ASCs published in Heart Rhythm Journal showing an emerging shift from the outpatient hospital facility to the ASC site setting.
Evidence from multiple sources indicate ablation procedures performed in the ASC would not pose a significant safety risk to patients appropriately selected by their EP and would meet statutory regulatory and safety requirements according to 42 CFR 416.166. The meeting closed with a request from CMS for the societies to submit comments in response to the proposed rule for calendar year 2025.