Program Information

The ASC Quality Reporting (ASCQR) Program is a quality measure data reporting program implemented by the Centers for Medicare & Medicaid Services for care provided in the ASC setting. The ASCQR Program exists to promote higher quality, more efficient health care for Medicare beneficiaries through data reporting, quality improvement, and measure alignment with other clinical care settings.

ASCs that meet program requirements during a given calendar year (CY) receive their full payment update for the upcoming CY; ASCs that do not participate or fail to meet those requirements may receive a two percent reduction of their payment update. To participate in the program, an ASC submits quality measure data; once an ASC submits any quality measure data under the ASCQR Program, the ASC is considered to be participating in the program.

Payment Determinations

CY 2020

The CY 2020 payment determinations will be based on Quality Data Codes (QDCs) submitted on Medicare Fee-for-Service claims with dates of service from January 1, 2018 through December 31, 2018, that are received in the Medicare Claims Warehouse by April 30, 2019. The minimum threshold for successful reporting is that at least 50 percent of Medicare claims meeting measure specifications contain the appropriate QDCs.

The submission of web-based measures ASC-9, ASC -10, ASC-13, and ASC-14 with reference to the clinical encounter time period of CY 2018 is also a program requirement. ASC-11 is a voluntary measure; any numeric value submitted will be publicly reported.

Data deadlines are subject to change; please visit www.qualitynet.org for the latest information.

Measures

Quality Data Codes

QDCs are specified CPT© Category II codes or Level II G-codes that describe the presence or absence of an event. One QDC is to be present for each relevant measure. To ensure compliance with program requirements, claims submitted to Medicare must include the appropriate codes.

Please see this chart to determine which QDCs to use for the four claims-based ASC Quality Measures.

Web-Based Measures

Aggregate data for web-based measures are submitted to CMS. Measures ASC-9, ASC -10, ASC-13, and ASC-14 are answered via the QualityNet Secure Portal. To submit web-based measure data and access reports, ASCs must have an active Security Administrator registered with QualityNet.

ASC-11 is a voluntary measure; any data submitted will be publicly reported.

More detailed information on program requirements and measures can be found in the ASCQR Program Reference Checklist and on QualityNet.

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