ASGE, ACG, and AGA submitted joint comments to CMS on the CY 2027 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) proposed rule.
Key recommendations include:
- Assigning the new upper and lower GI ESD codes to APC 5331 (Complex GI Procedures).
- Reconsidering the ASC payment scalar methodology.
- Establishing transparent, sustainable payment policies for Software as a Medical Service (SaMS).
- Opposing accelerated 340B remedy recoupment through a 3 percent annual OPPS reduction.
- Evaluating the cumulative impact of Medicare payment changes across settings.
- Removing the OP-29 and ASC-9 colonoscopy follow-up interval quality measures.
The GI socieities urged CMS to adopt evidence-based policies that appropriately recognize the resources required to provide complex GI services and preserve Medicare beneficiary access to care.