Partner News | Published: Friday, November 12, 2021 12:00 pm
In the past 10 years, we’ve seen Medicare shift many cardiovascular procedures to the outpatient site of service: PAD, EP implants, diagnostic coronary caths, PCI and complex PCI. In an unprecedented move, Medicare removed 255 cases from the ASC payable list for 2022, and several of these cases impact cardiovascular procedures. Optimism is still very high on cardiovascular outmigration with over 100 operational Cardiovascular ASCs and several dozen currently under development across the US.
Thanks to a valiant effort by the Cardiovascular Coalition (CVC), the cuts could have been worse. However, the cuts should come as no surprise as Medicare has proposed significant cuts in PAD reimbursement in the OBL since 2015. With the AMA’s reclassification of lower extremity CPT codes for 2023, more cuts could be coming in 2023.
In conclusion, while removing these codes from the ASC approved list for 2022 won’t materially impact the financial performance of many Cardiovascular ASCs, it sets a concerning precedent that Medicare can randomly remove previously approved cases in our ASCs. We can do our part by delivering excellent clinical outcomes by adhering to appropriate use criteria and participating in data collection. All key stakeholders should consider collaboration and participation in proper representation in Washington DC to ensure our ASCs are effectively represented.