ASC Daily Briefing — June 25, 2026

By consulting | June 25, 2026 |

🔴 Urgent / Action Required

CMS Prior Authorization Demonstration — Active in 10 States
The 5-year PA demonstration for certain ASC services is fully live in all 10 states (CA, FL, TX, AZ, OH, TN, PA, MD, GA, NY). Targeted procedures: blepharoplasty, botulinum toxin injections, panniculectomy, rhinoplasty, and vein ablation. Claims without a Unique Tracking Number (UTN) are subject to prepayment review and potential denial. Ensure your billing team is including UTNs on all applicable claims.
Sources: ASCA — CMS Delays PA Start Date | CMS PA Demonstration

AAAHC v45 Public Comment Period — CLOSED April 2, 2026
The public comment period for proposed v45 Standards additions and revisions closed April 2, 2026. Final v45 Standards are expected to be announced soon. Prepare your team for the first full survey year under v45 once published.
Source: AAAHC v45 Stakeholder Input

📋 Regulatory Updates

CY 2026 OPPS/ASC Final Rule — Key Provisions in Effect
The CY 2026 Final Rule (CMS-1834-FC), effective January 1, 2026, includes: a 2.6% ASC payment rate increase (market basket 3.3% minus 0.7% productivity adjustment); 560 new procedures added to the ASC Covered Procedure List (including 271 removed from the IPO list); and launch of the 3-year phase-out of the Inpatient-Only list, with full elimination by January 1, 2029.
Sources: CMS Fact Sheet | Federal Register

New Drug/Device Separate Payment
For CY 2026, five drugs and thirteen devices qualify for separate payment in the ASC setting. CMS will now evaluate new products quarterly rather than annually, with payments applied retroactively to eligibility date. A new $10 per-dose add-on payment (HCPCS C9176) applies to radiopharmaceuticals using technetium-99m derived from domestically produced molybdenum-99.
Source: CMS CY 2026 Fact Sheet

CY 2027 OPPS/ASC Proposed Rule — Anticipated
CMS completed a mandatory Drug Acquisition Cost Survey (January–March 2026) to inform CY 2027 policy. CMS has signaled it will propose a larger 340B payment reduction (potentially 2%) in the CY 2027 proposed rule. Watch for the proposed rule release, typically in July.
Source: Applied Policy

ASCQR Quality Reporting Reminder
ASCs failing to meet ASCQR quality reporting requirements are subject to a 2.0 percentage point payment reduction. Verify your reporting submissions are current and complete.
Source: CMS ASC Payment

ASC Infection Control — Common Survey Deficiencies
CDC/CMS data continues to show high infection control deficiency rates at ASCs: 67.6% of surveyed ASCs had at least one IC finding. Top citations include single-dose vial misuse (28.1%), equipment reprocessing failures (28.4%), and blood glucose monitoring equipment failures (46.3%). Review your IC program against 42 CFR §416.51.
Source: CMS ASC Requirements Guide

🏅 Accreditation News

AAAHC v44 — First Full Survey Year Underway
2026 is the first full survey year under AAAHC v44 Standards. Surveyors are applying v44 requirements in all surveys, including expanded data collection/outcomes focus and alignment with state scope of practice rules.

AAAHC v45 — AI Governance Added, Educational Programs Announced
AAAHC announced educational programs for v45 readiness: virtual September 14–16, 2026, and onsite December 10–11, 2026 (Red Rock Casino, Las Vegas). A significant new addition in v45 requires clinical oversight and ethical governance frameworks for use of AI in ambulatory care. All AAAHC programs are impacted, including Medicare deemed status.
Sources: AAAHC v45 Educational Programs | ASC Focus

Joint Commission — Physical Environment Standards Consolidated
In 2026, The Joint Commission combined the Environment of Care and Life Safety chapters into a single Physical Environment chapter. Overall, TJC has reduced its standards by approximately 50% over the past year. This significantly simplifies survey prep for TJC-accredited ASCs.
Source: OR Today — Accreditation 2026

QUAD A — Rural Health Clinic Accreditation
A Federal Register notice (March 10, 2026) covers QUAD A’s application for continued CMS approval of its Rural Health Clinic accreditation program. No action required unless your facility operates as an RHC.
Source: Federal Register 2026-04595

📰 Industry News

IPO Phase-Out — Significant Opportunity for ASCs
With 271 musculoskeletal procedures removed from the IPO list effective January 1, 2026, this is one of the largest expansions in ASC procedure eligibility in history. ASCs should be actively evaluating newly eligible procedures — particularly orthopedic and spine cases.

Outpatient Surgery Access Act of 2026
Introduced March 25, 2026, by Reps. Beth Van Duyne (R-TX) and John Larson (D-CT), this bill would align annual ASC payment updates with HOPDs beginning 2027 and eliminate the ASC-specific budget-neutrality adjustment. Track with ASCA for advocacy opportunities.
Source: Congressman Larson — $27.9B ASC-HOPD Gap

340B Offset — Watch for 2027 Proposed Rule
CMS declined to accelerate 340B offsets in the CY 2026 final rule (held at 0.5% reduction), but signaled a potential 2% or larger reduction beginning CY 2027. If your ASC participates in 340B, model the impact now.
Source: Applied Policy

Sources

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