The ASC Quality Reporting Program, established by the Centers for Medicare & Medicaid Services (CMS), is a crucial initiative to improve the quality and transparency of ambulatory surgical care in the United States. At Medical Billers and Coders (MBC), we understand the complexities of Medicare compliance and strive to help ASCs navigate reporting requirements effectively.
What is the ASC Quality Reporting Program?
The ASC Quality Reporting Program is a pay-for-reporting system designed to collect and publicly share quality data from ambulatory surgical centers (ASCs). ASCs that fail to meet reporting requirements risk a 2% reduction in their annual payment update from Medicare.
2025 Reporting Measures for ASCs
For 2025, the ASC Quality Reporting Program mandates the reporting of 14 quality measures, 10 of which require direct action from ASCs. These measures focus on patient safety, post-procedure outcomes, and operational quality.
Key Measures for 2025:
- ASC-1: Patient Burn – Tracks instances of burns sustained by patients during procedures.
- ASC-2: Patient Fall – Reports on falls occurring within the ASC setting.
- ASC-3: Wrong Site, Wrong Procedure, Wrong Patient – Identifies surgical errors related to patient identification and procedure accuracy.
- ASC-4: All-Cause Hospital Transfer/Admission – Measures cases where patients require hospital admission post-surgery.
- ASC-9: Endoscopy/Polyp Surveillance – Ensures appropriate follow-up intervals for colonoscopies.
- ASC-13: Normothermia Outcome – Assesses patients’ ability to maintain normal body temperature post-anesthesia.
- ASC-14: Unplanned Anterior Vitrectomy – Tracks unplanned vitrectomies during cataract surgeries.
- ASC-15: OAS CAHPS Survey – Gathers patient feedback on surgical care experiences.
- ASC-17 to ASC-19: Hospital Visits After Surgery – Monitors hospital visits following orthopedic, urology, and general surgical procedures.
- ASC-20: COVID-19 Vaccination Coverage – Reports on healthcare personnel vaccination status.
How ASCs Can Ensure Compliance
- Accurate Data Collection – Maintain precise records for quality measures and submit data through the CMS Hospital Quality Reporting (HQR) Secure Portal.
- Adherence to Deadlines – Ensure all reports are submitted on time. Data collection for 2025 must be completed and submitted by May 15, 2026.
- Leverage Technology – Use EHR systems and medical billing software to streamline data collection and submission.
- Regular Performance Monitoring – Conduct internal audits to track compliance and identify areas for improvement.
Why Compliance Matters for ASCs
ASCs fully complying with the ASCQR Program receive their full Medicare reimbursement, ensuring financial stability and operational efficiency. Among the 6,012 ASCs assessed for the 2025 payment determination, 5,714 will receive full updates, highlighting the importance of maintaining compliance.
At MBC, we specialize in ASC Billing and Coding. We guide ASCs through complex Medicare compliance and quality reporting requirements. Our team ensures that your ASC meets all CMS regulations, prevents payment penalties, and enhances operational efficiency.
Need help with ASC Quality Reporting? Contact MBC today at 888-357-3226 to ensure compliance and maximize your reimbursements.
FAQs
A1: The ASCQR Program is a CMS initiative that collects quality data from ambulatory surgical centers (ASCs) to enhance care quality and transparency.
A2: ASCs that fail to report required measures may face a 2% annual Medicare payment update reduction.
A3: Some critical measures include patient burns, falls, wrong-site surgeries, hospital transfers, polyp surveillance, and healthcare staff COVID-19 vaccination coverage.
A4: ASCs should maintain accurate records, meet submission deadlines, use EHR systems, and conduct internal audits to track performance.
A5: MBC provides expert guidance to help ASCs navigate Medicare compliance, avoid payment penalties, and streamline reporting processes. Contact 888-357-3226 for assistance.
