The following Q&A comes from the Centers for Medicare & Medicaid Services website.
Q: Does CMS adjust Ambulatory Surgical Center (ASC) payment under the revised ASC payment system for geographic differences in wages based on where the ASC is located?
CMS: Starting in 2008, CMS adjusts for geographic differences in wages using the Core Based Statistical Area (CBSA) geographic locality definitions established in 2003 by the Office of Management and Budget (OMB). These geographic locality definitions replace the Metropolitan Statistical Area (MSA) definitions that were used as the basis for ASC wage adjustments prior to January 1, 2008. Adopting the CBSA geographic definitions is consistent with wage index policy under other CMS payment systems. The ASC payment system is one of the last to adopt the CBSA definitions. The wage index assigned to a specific ASC reflects the geographic labor area where an ASC is physically located. ASCs may not appeal for wage index reclassification as this process is specific to hospitals.
Additionally, starting in 2008 the wage index values used to adjust payment for procedures under the revised ASC payment system are based on the applicable annually updated pre-reclassification wage index that CMS uses to pay almost all non-acute providers. These wage indices do not include acute inpatient specific adjustments, including reclassification, floor provisions, or occupational mix adjustments. The pre-reclassification wage index by CBSA is available on CMS's website in the Federal Register ASC final rulemaking. These final changes are published annually. The ASC final rules are accessible online at: www.cms.hhs.gov/ASCPayment/ASCRN/list.asp#TopOfPage.
Payment rates for each ASC covered surgical procedure and ancillary service before adjustment for regional wage variations and wage indices are updated quarterly as appropriate, and available on the CMS web site at: www.cms.hhs.gov/ASCPayment/11_Addenda_Updates.asp#TopOfPage. See the Medicare Claims Processing Manual, Chapter 14, Section 40.2 for more information.
Source: CMS
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