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ASC & Hospital Outpatient

Medicare payment rates for ambulatory surgical centers (ASCs) and hospital outpatient departments directly affect where patients can receive surgical eye care — and at what cost.

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The vast majority of ophthalmic surgical procedures — including cataract surgery, glaucoma procedures, and retinal treatments — are performed in ambulatory surgical centers and hospital outpatient departments. The Medicare payment rates for these settings are not a technical footnote: they determine whether ASCs can remain financially viable, whether patients can access care close to home, and whether ophthalmologists can continue to offer high-quality outpatient surgical care. 

Each year, CMS updates HOPD and ASC payment rates through a formal rulemaking process. The Academy reviews every proposed rule, submits formal comments, and works with coalition partners to ensure that CMS decisions are grounded in accurate data and reflect the true cost of ophthalmic surgical care. When CMS gets it wrong — as it did in 2025, when a calculation error would have cut cataract surgery ASC reimbursement by 4.7% — the Academy acts. 

The Academy also monitors broader payment policy trends, including site neutrality proposals that would reduce payments to hospital outpatient departments and could reshape where patients receive surgical care. 

Ambulatory Surgical Center (ASC) Payment

Medicare payment rates for ambulatory surgical centers affect ophthalmologists' ability to provide cost-effective surgical care to their patients. 

Hospital Outpatient Department (HOPD) Payment

Medicare payment rates for hospital outpatient departments shape where and how ophthalmologists can deliver surgical care to their patients.

Quality Reporting for Ambulatory Surgery Centers (ASCs)

Federal quality reporting requirements for ambulatory surgery centers affect ophthalmologists and may include measures not designed or appropriate for the ASC setting.

Take Action: ASC & HOPD Payment

Each summer, CMS proposes new ASC and HOPD payment rates. When the Academy issues a call to action, your comments—especially around clinical experience—carries weight.

Learn How to Get involved

Latest News

See All ASC & Hospital Outpatient News
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CMS Tests Prior Authorization for Some ASC Services

The Centers for Medicare & Medicaid Services (CMS) has introduced a new pilot program requiring prior authorization (PA) for fee-for-service Medicare for certain services in ambulatory surgical centers (ASCs).

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How Two Controversial Medicare Policies Attack Surgical Care

The Academy’s team of health policy experts have analyzed finalized Medicare policies slated to begin Jan. 1, 2026, and outline the details of the most controversial policies. We are running out of time for Congress to act and stop these policies from harming your patients. Act today.

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CMS Finalizes 2026 2.6% Pay Increase for Hospital Outpatient Departments, ASCs

The final rule could affect about 4,000 hospital outpatient departments and 6,000 ambulatory surgical centers (ASC).

Our Advocacy in Action

The Academy tracks every CMS rulemaking that affects ASC and HOPD payment — and intervenes when proposed rules would harm ophthalmology practices and their patients.

Learn More About Our Impact
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$125 Million
In ASC cataract surgery cuts prevented after the Academy pushed CMS to correct a flawed 2026 payment rate calculation.
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2.6%
HOPD and ASC payment rate increase secured for 2026 through sustained Academy advocacy for accurate, market-based payment updates.

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OPHTHPAC

The Academy’s political action committee, OPHTHPAC, advocates at the federal level for our members and the patients they treat on critical issues affecting ophthalmology.
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Surgical Scope Fund

Help derail dangerous scope of practice expansion initiatives at the state level that put patient safety at risk by supporting the Surgical Scope Fund.
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