August 4, 2020
2021 ASC Conversion Factor Projected at $48.984 for ASCs Meeting Quality Reporting Requirements
Today, the Centers for Medicare & Medicaid Services (CMS) issued the Calendar Year (CY) 2021 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Policy Changes and Payment Rates proposed rule. The rule has a 60-day comment period, and ASCRS will be providing comments.
ASC Conversion Factor
For CY 2021, CMS proposes to adjust the CY 2020 ASC conversion factor ($47.747) by the wage adjustment budget neutrality factor of 0.9999 in addition to the MFP-adjusted hospital market basket update factor of 2.6%, which results in a proposed CY 2021 ASC conversion factor of $48.984 for ASCs meeting the quality reporting requirements.
For ASCs not meeting the quality reporting requirements, CMS is proposing to adjust the CY 2020 ASC conversion factor ($47.747) by the wage adjustment for budget neutrality factor of 0.9999 in addition to the quality reporting/MFP-adjusted hospital market basket update factor of 0.6%, which results in a proposed CY 2021 ASC conversion factor of $48.029 for ASCs not meeting the quality reporting requirements.
ASC Center Quality Reporting (ASCQR) Program
The ASCQR Program is a pay-for-reporting quality program for the ASC setting. The ASCQR Program requires ASCs to meet quality reporting requirements or receive a reduction of 2.0 percentage points in their annual fee schedule update if these requirements are not met. CMS is not proposing to add or remove any measures in this rulemaking.
Additional information will be detailed in upcoming editions of Washington Watch Weekly.