CMS also released the Medicare Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System proposed rule for 2021. Here CMS has proposed the elimination of the inpatient only list (IPO), which would mean removal of nearly 300 musculoskeletal procedures from the IPO that could be done in an outpatient setting. CMS also proposes adding total hip arthroplasty to the ambulatory surgery center covered procedures list (CPL), making total hip arthroplasty eligible for Medicare reimbursement. Medicare notes that when appropriate, payment for inpatient care will continue when “determined by the physician.” Read the summary (starting on p. 6) by Epstein Becker & Green.
CMS Proposed Rule Adds Hip Replacement to ASC List
Aug 6, 2020 | CMS
What does the potential reimbursement look like in the ASC for the THR – Many patients are excited to have the total hip done in the ASC with all the Covid push back. We want to get them on the books but have no idea how it reimburses. Please advise