Ambulatory Surgery Centers NAICS 621493

Jul 5, 2025 - US Senate Ignores Request To Change Medicare Fee Schedule

• Federal legislators ignored a request by a group of medical societies and physician groups to change the Senate proposal for the 2026 Medicare Physician Fee Schedule to match one that was passed in the US House of Representatives version of the One Big Beautiful Bill reconciliation legislation. The 75 groups and societies said that the Medicare Payment provision in the House-passed One Big Beautiful Bill represents a "critical step" toward stabilizing the Medicare Physician Fee Schedule. The Senate passed its version of the reconciliation legislation on July 1 without adjusting its 2026 Medicare Physician Fee Schedule proposal. The legislation signed into law by President Trump included the unmodified Senate proposal which, like the US House version, contains a one-year 2.5% increase in the Medicare Physician Fee Schedule conversion factor for 2026. Medicare physician payments have decreased 33% since 2001 when adjusted for inflation, according to Healthcare Finance, with visible consequences, including the loss of independent physicians and practices in rural areas. The Senate version of the bill also includes steeper cuts to Medicaid than the projected $715 billion in the House version of the bill that passed in May.
• A structural reimbursement crisis affecting hospitals would only get worse if more site-neutral payment policies are enacted to allow ambulatory surgery centers (ASCs) to be paid as much as hospital outpatient departments (HOPDs) receive for performing identical procedures, according to the American Hospital Association (AHA). Hospitals have a higher cost structure than independent physician offices (IPOs) and ASCs due in part to the costs of standby capability and capacity, according to the AHA. This standby role is built into the cost structure of hospitals and supported by revenue from direct patient care — a situation that does not exist for any other type of provider. HOPDs aren’t simply same-day surgical centers for health systems, according to the AHA. They also provide complex cancer, infectious disease, mental health and other services — and therefore should not be paid the same Medicare rate as standalone physician offices.

• Certificate-of-Need (CON) laws, which restrict construction and/or expansion of healthcare facilities, may have reduced access to medical care, according to the CATO Institute. CON laws, which are in place in 35 states, require hospitals, nursing homes, ambulatory surgical centers (ASCs), and other healthcare providers to obtain regulatory approval before opening a new practice, expanding, or making certain capital investments. Medical care in those states is higher-cost and lower-quality than in states without CON laws, according to CATO research, but the majority of this research shows correlations but does not show that CON laws cause reduced access, higher expenditures, and lower quality.
• Ambulatory surgery center industry employment decreased slightly and average wages for nonsupervisory employees increased moderately during the first five months of 2025, according to the US Bureau of Labor Statistics (BLS). Ambulatory surgery centers sales are forecast to grow at a 5.75% compounded annual rate from 2025 to 2028, faster than the growth of the overall economy, according to Inforum and the Interindustry Economic Research Fund.