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No More Empty Beds - Outpatient Surgery Magazine - February 2020

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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F E B R U A R Y 2 0 2 0 • O U T PA T I E N T S U R G E R Y. N E T • 1 9 CMS added 17 cardiac diagnostic procedures to the ASC- approved list last year, which has paved the way for six new stent-related inter- vention procedure codes (CPT codes 92920, 92921, 92928, 92929, C9600, C9601) in 2020. In 2016, according to data in the Medicare Provider Access and Review (MEDPAR) file, Medicare beneficiaries underwent more than 523,000 cardiac catheterizations on an outpatient basis in hospitals, resulting in an estimated $682 million in payments, according to Ronald Hirsch, vice president of regulations and education for R1 RCM's Physicians Advisory Solutions, a consulting firm based in Chicago, Ill. In 2020, CMS will reimburse hospital outpatient departments $2,899 and ASCs $1,377 for a cardiac catheterization procedure. For a cardiac catheterization with a stent, the proposed rate is $10,013 for HOPDs and $6,203 for ASCs. On average, eight to 10 stent procedures can be performed in one operating room each day. The cost per case is approximately $2,000, so an HOPD would make about $8,000 and an ASC would make about $4,200 for each procedure performed. — Adam Taylor PIECE OF THE PIE Preview of Payment Rates

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