CMS pushes outpatient cardiology shift

CMS’s 2026 outpatient payment rule did more than raise rates. It widened the list of procedures Medicare will cover in ambulatory surgery centers, including a set of cardiovascular services that cardiology groups and ASC operators had been pressing to move out of hospitals. Becker’s ASC reported that the change has become a focal point in forecasts for how cardiology practice will evolve over the next decade. The policy change is concrete. CMS’s final rule for calendar year 2026 revised the hospital outpatient and ASC payment systems, and outside groups tracking the rule said it substantially expanded the ASC covered procedures list. The Ambulatory Surgery Center Association said CMS finalized 573 additions to the ASC-CPL for 2026, including cardiovascular codes for electrophysiology studies and ablations, percutaneous coronary intervention, cardioversion and transesophageal echocardiogram. (beckersasc.com) ### Which cardiology procedures did CMS actually add? Becker’s ASC reported on November 25, 2025 that CMS added codes for cardiac catheter ablation procedures, percutaneous coronary interventions and vascular embolisms or occlusions in the 2026 final rule. The same Becker’s report said the additions followed advocacy from groups including the American College of Cardiology and the Heart Rhythm Society. (ascassociation.org) ASCA’s November 21, 2025 summary listed the cardiovascular additions in more detail. It said the rule added electrophysiology studies and ablations under codes 93619, 93620, 93642, 93650, 93653, 93654, 93656 and 93724, plus PCI codes C9602, C9604 and C9607, and cardioversion and transesophageal echocardiogram codes 92960, 93312 and 93318. ### Why are people treating this as more than a reimbursement update? (beckersasc.com) Richard Chazal, medical director of heart health at Lee Health’s Lee Heart Institute in Fort Myers, Florida, told Becker’s in January that cardiology had already been moving toward outpatient settings and that the shift had been accelerated by technology and payer incentive alignment. Becker’s said CMS approved four cardiovascular codes for electrophysiology studies and ablations and three for PCI in the 2026 final rule. (ascassociation.org) Chazal told Becker’s that some electrophysiology procedures and device insertions had matured to the point that they could be performed in lower-cost outpatient centers. He also pointed to less invasive valve treatment as a next frontier, saying transcatheter aortic valve replacement has shortened hospital stays as techniques and equipment improved. ### What else in the rule makes outpatient migration easier? (beckersasc.com) CMS also changed the structure of the ASC covered-procedure policy. Becker’s ASC reported that the final rule eliminated five general exclusion criteria and shifted them into a new section of “nonbinding physician considerations for patient safety,” citing a CMS press release. ASCA said CMS revised the criteria at section 416.166 and, based on those changes, added 302 procedures to the ASC-CPL before counting additional codes tied to the inpatient-only list transition. (beckersasc.com) The same Becker’s report said OPPS payment for stress tests and other services in Level 2 Diagnostic Tests APC would fall to $220.60 from $311.40. That is a hospital-outpatient payment detail, but it underscores that site-of-care economics and code-level reimbursement changes are moving together. ### Where do the official lists live now? CMS’s ambulatory surgery center payment page says the agency maintains approved HCPCS codes and payment-rate files for procedures that may be performed in an ASC under Medicare. (beckersasc.com) The page, last modified March 10, 2026, also points providers to current reimbursement policies and archived payment files. The next formal milestone is the CY 2026 proposed-rule comment deadline that CMS lists as September 15 on its ASC payment page, while the 2026 final rule published in the Federal Register on November 25, 2025 remains the governing document for the current payment year. (beckersasc.com) (cms.gov)