2020 ASC Conversion Factor is $47.747 for ASCs Meeting Quality Reporting Requirements


On November 1st, the Centers for Medicare & Medicaid Services (CMS) issued the Calendar Year (CY) 2020 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Payment System Policy Changes and Payment Rates final rule. CMS also released a fact sheet on this final rule.

Updates to ASC Payments

For CY 2020, CMS adjusted the CY 2019 ASC conversion factor ($46.532) by 1.0001 to account for changes in the pre-floor and pre-reclassified hospital wage indexes between CY 2019 and CY 2020 and by applying the CY 2020 multifactor productivity (MFP) adjusted hospital market basket update factor of 2.6% (which is equal to the projected hospital market basket update of 3.0% minus an MFP adjustment of 0.4%). The final 2020 ASC conversion factor is $47.747.

For ASCs that fail to meet their quality reporting requirements, the CY 2020 payment determinations will be based on the application of a 2.0% reduction to the annual update factor.

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 will not remove any measures in this rulemaking, as the agency's analysis of the current ASCQR Program measure set indicates that there are no measures that meet the measure removal factors following last year’s comprehensive removal initiative. CMS is adopting one claims-based measure beginning with the CY 2024 payment determination, ASC-19: Facility-Level 7-Day Hospital Visits after General Surgery Procedures Performed at Ambulatory Surgical Centers (NQF #3357).

Additional information will be detailed in upcoming editions of Washington Watch Weekly. For questions, please contact Allison Madson, manager of regulatory affairs, at 703-591-2220 or amadson@ascrs.org.