CMS makes 2 ASC rate technical corrections, adjusts scalar for 2021

Laura Dyrda - Print  |

CMS incorporated two ASC rate technical corrections into the Outpatient Prospective Payment System/ASC final rule to match the physician fee schedule change late last year.

CMS updated the physician fee schedule conversion factor to $34.89 on Dec. 27 as a result of the Consolidated Appropriations Act. The new conversion factor is higher than the conversion factor in the 2021 final rule released a few weeks earlier but 3.3 percent lower than the 2020 conversion factor. The agency also recalculated ambulatory surgery center rates for office-based procedures and some covered ancillary radiology and diagnostic tests.

Effective Jan. 1, CMS made two ASC rate technical corrections to reflect the 2021 OPPS/ASC final rule policies:

1. Accounting for separate payments for HCPCS code J1097 in the budget neutrality adjustment
2. Applying a 31 percent default device offset for transcervical uterine fibroid ablation with ultrasound guidance and radiofrequency

CMS uses a weighted scalar to contain costs, and the ASC scalar for 2021 is now 0.8547, down slightly from 0.8550 in 2020.

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