2025 Medical Final Rule: Key Takeaways for ASCs

Takeaways from the CMS' 2025 final payment rule for ASCs and HOPDs

In the Ambulatory Surgery Center Association's initial summary of the Centers for Medicare & Medicaid Services' (CMS) 2025 final payment rule for ASCs and hospital outpatient departments, ASCA Chief Executive Officer Bill Prentice stated, "This final rule is a step sideways in a time when millions of Medicare beneficiaries need CMS to advance policies that expand access to the safe, convenient and efficient care that surgery centers provide."

Why did Prentice feel this way? It becomes apparent when looking at the biggest takeaways for ASCs from the 2025 final rule.

1. CMS approved a 2.9% payment increase for ASCs. That's close to but still lower than the 3.1% increase ASCs received for 2024 and nearly a full point lower than the 3.8% increase received for 2023.
2. CMS approved the addition of 21 procedures to the Medicare ASC Covered Procedures List: 19 dental codes and two adipose-derived regenerative cell therapy codes. More noteworthy is that CMS chose not to add any of the cardiac and spine codes ASCA had submitted for consideration, eliminating the hope that the agency might repeat the surprise turn of events seen in last year's final rule.
3. CMS finalized the addition of three new quality measures to the ASC Quality Reporting Program:
   1. Facility Commitment to Health Equity
   2. Screening for Social Drivers of Health
   3. Screen Positive Rate for Social Drivers of Health

These additions received pushback when they were included in the 2025 proposed rule, with David Shapiro, MD, CASC, who serves on ASCA's board of directors, telling Outpatient Surgery Magazine, "Health equity, social determinants and social drivers of health are important issues, but the idea of us in an ASC environment really having an impact on any of them is beyond ludicrous."

Access ASCA's final rule summary here and CMS's final rule fact sheet here.