Printer-friendly version

Medicare Rate Calculator

2015 Proposed Medicare Rate Calculator

This calculator shows your proposed national and local payment rates for 2015. Simply look up your local wage index from the easy to use chart and type it into the calculator and the calculator does the rest. (These rates are proposed; 2015 final rates may vary.)

Please note: Due to a 2015 change in policy, some counties’ wage indices will be subject to a blended rate for 2015 (50% based on the 2014 CBSA and 50% based on the 2015 CBSA). ASCA is identifying which counties will be impacted and trying to amend the rate calculator by the final version to factor in these counties. We have used 2015 CBSAs for this document, so if your county is impacted, the rate you receive would actually be slightly higher than indicated in the rate calculator.

2014 Final Medicare Rate Calculator

This calculator shows your national and local payment rates for 2014. Simply look up your local wage index from the easy to use chart and type it into the calculator and the calculator does the rest.

Additional Medicare Payment Resources

2015 Proposed Medicare Payment Resources

   

2014 Final Medicare Payment Resources

2015 Proposed ASC Rates Compared to HOPD Rates
This chart compares the proposed 2015 ASC rates with the proposed 2015 HOPD rates for the same surgical procedures.

   

2014 ASC Rates Compared to HOPD Rates
This chart compares the 2014 ASC rates with the 2014 HOPD rates for the same surgical procedures.

2015 Proposed Separately Payable Procedures
This document provides the proposed list of procedures that are payable in an ASC in 2015 and for which there is a separate payment made. The CPT code and the 2015 proposed national ASC rate are provided. This list does not include packaged procedures.

   

2014 Separately Payable Procedures Codes
This document provides the list of procedures that are payable in an ASC in 2014 and for which there is a separate payment made. The CPT code and the 2014 national ASC rate are provided. This list does not include packaged procedures.

2015 Proposed Packaged Procedures
This chart lists the procedures that are on the proposed 2015 ASC list, but for which there are no separate payments because payments for these packaged procedures are included in the payments made for other procedures.

   

2014 Packaged Codes
This chart lists the procedures that are on the 2014 ASC list, but for which there are no separate payments because payments for these packaged procedures are included in the payments made for other procedures.

2015 Proposed Ancillary Services
This chart provides the proposed list of covered ancillary services for 2015. ASCs may bill for ancillary services when provided in conjunction with covered surgical procedures. This list will be updated quarterly to reflect changes made by Medicare.

   

2014 Ancillary Services
This chart provides the list of covered ancillary services for 2014. ASCs may bill for ancillary services when provided in conjunction with covered surgical procedures. This list will be updated quarterly to reflect changes made by Medicare.

2015 Proposed Device Intensive Procedures
This chart lists the proposed procedures classified as device intensive in 2015 and their 2015 ASC payment rate.

   

2014 Device Intensive Procedures
This chart lists the procedures classified as device intensive in 2014 and their 2014 ASC payment rate.

2015 Proposed Office Based Procedures
This chart lists the proposed procedures classified as office based for 2015, their proposed 2015 payment rates, and whether the rates are based on the hospital outpatient department rates or on the physician's practice expense rates.

   

2014 Office Based Procedures
This chart lists the procedures classified as office based for 2014, their 2014 payment rates, and whether the rates are based on the hospital outpatient department rates or on the physician's practice expense rates.

2015 Proposed Multiple-Procedure Discounting Exempt
This chart shows the proposed procedures exempt from multiple-procedure discounting in 2015 and their proposed 2015 ASC payment rate.

   

2014 Multiple-Procedure Discounting Exempt
This chart shows the procedures exempt from multiple-procedure discounting in 2014 and their 2014 ASC payment rate.

2015 Proposed Patient Cost Sharing Waived Services
This chart shows the proposed services for which the patient copayment and deductible are waived for 2015. CMS did not propose any changes to the current (2014) list of cost sharing waived services.

   

2014 Patient Cost Sharing Waived Services
This chart shows the services for which the patient copayment and deductible are waived for 2014.




   

Procedures Subject to CMS Device Adjustment Policy
This is the list of ASC Procedures to which the No Cost/Full Credit and Partial Credit Device Adjustment Policy Applies.


   

2014 New Packaged Codes
This chart shows only the procedures that are newly packaged this year that were separately payable last year.


   

2014 ASC List Changes
This chart lists codes that have been added to and deleted from the ASC list of payable procedures and the reason for addition/deletion.


- - - - -


While there is no substitute for receiving a legal opinion regarding the specific facts in a particular case from qualified counsel that practice in this specialized area of law, the Federal Regulations section of ASCA’s website provides a starting point for understanding the federal rules impacting ASCs. For questions or more information, contact Kara Newbury at knewbury@ascassociation.org.


Reproduction in whole or in part without written permission from ASCA is prohibited.