ASCA

A bipartisan House bill introduced March 25 would permanently extend a more favorable Medicare inflation update for ambulatory surgery centers (ASCs). It would also block another type of payment adjustment that the industry argues could hold ASC reimbursement down. The legislation – the Outpatient Surgery Access Act of 2026 – was introduced by Reps. Beth Van Duyne (R-Texas) and John Larson (D-Conn). If enacted, it would align annual payment updates for ASCs with hospital outpatient … [Read more...]

For years, ambulatory surgery center (ASC) operators have faced a basic reimbursement dilemma in post-surgical pain care. Opioids are cheap and easy to use, while some non-opioid alternatives are harder to justify from a payment perspective. The Non-Opioids Prevent Addiction in the Nation (NOPAIN) Act is meant to address that conundrum. The law, enacted in late 2022 and effective Jan. 1, 2025, temporarily allows separate Medicare payment for qualifying non-opioid drugs, biologics and … [Read more...]

More cardiovascular (CV) procedures are coming to ambulatory surgery centers (ASCs), but the barrier to entry remains high. Varied state regulations, high capital costs and tight staffing are likely to limit the pace of outpatient migration for these CV procedures, industry insiders told ASC News. “I don't think we're going to see a huge shift in volume in the first couple of years,” Kara Newbury, chief advocacy officer at the Ambulatory Surgery Center Association (ASCA), told ASC … [Read more...]

Ambulatory surgery centers (ASCs) are primed for growth, but this rising tide won’t lift all boats. Making the most of what promises to be a positive year for the sector will require disciplined planning, targeted investment, and a clear-eyed view of regulatory and reimbursement risk.  This was the overarching message of a recent ASC News webinar focused on 2026 payment dynamics and growth strategies. “We’re going to grow, which is great; we just need to figure out how to do the … [Read more...]

One of the largest health insurers in the nation is pushing a new out-of-network policy that could prove seriously challenging for ambulatory surgery centers (ASCs). Starting Jan. 1, 2026, Anthem will penalize hospitals, surgery centers and other facilities whenever those facilities use out-of-network providers for patients covered under Anthem commercial plans. In other words, the insurer is putting financial pressure on facilities to use only in-network resources, except in certain … [Read more...]

The U.S. Centers for Medicare & Medicaid Services (CMS) is delaying the implementation of its five-year prior-authorization demonstration for ambulatory surgery centers (ASCs). Originally, the prior-auth demo was set to go live in December 2025 across all participating states: California, Florida, Texas, Arizona, Ohio, Tennessee, Pennsylvania, Maryland, Georgia and New York. Now, the demo will be rolled out in two phases. ASCs in California, Florida, Tennessee, Pennsylvania, Maryland, … [Read more...]

The Centers for Medicare & Medicaid Services (CMS) has released the 2026 Medicare Physician Fee Schedule (PFS) final rule, which, as always, has a few key takeaways for ambulatory surgery centers (ASCs). The agency says the rule is focused on modernizing payment accuracy by finalizing an “efficiency adjustment” for select services and a one-time 2.5% increase in physician payments. “CMS is working to strengthen and transform Medicare for current and future generations while cracking … [Read more...]

The federal government officially shut down on Oct. 1 after Congress failed to reach agreement on a short-term spending bill. The immediate fallout will mean furloughs for hundreds of thousands of federal workers and stalled services across multiple agencies. For ambulatory surgery centers (ASCs), the impact may not be as direct as it is for hospitals or other federally funded programs, but industry leaders say ripple effects could be on the horizon if Congress does not act soon. “If … [Read more...]

The U.S. Centers for Medicare & Medicaid Services (CMS) floated big changes to the outpatient surgery landscape when the agency shared its 2026 proposed payment rule for ambulatory surgery centers (ASCs) on July 15. To recap, CMS’ proposal included doing away with the Medicare Inpatient Only List (IPO), adding to the ASC Covered Procedures List (ASC-CPL) and giving ASCs a relatively modest payment adjustment. CMS likewise proposed changes to the Ambulatory Surgical Center Quality … [Read more...]

Electronic health record (EHR) usage among ambulatory surgery centers (ASCs) continues to climb. That’s according to the Ambulatory Surgery Center Association’s (ASCA) July 2025 60-Second Survey. The survey found that 76% of ASCs now use an EHR. That’s the highest percentage since ASCA began asking the question in 2021, reflecting the increasing importance of EHR technology. “It's probably a few industry [and] health care trends happening simultaneously,” ASCA regulatory counsel Alex … [Read more...]