Special Alert March 2026 - Implementation of Multiple Surgery Reduction (MSR) Rules for Endoscopic Procedures Billed by Ambulatory Surgery Centers (ASCs)

By March 4, 2026: Billing team must immediately update ASC billing software to implement MSR logic for endoscopic procedures. Specifically: (1) Configure system to identify endoscopy procedures from the same family and apply special endoscopy reduction rules where only the highest-valued procedure pays at 100% and subsequent same-family procedures pay at the difference amount; (2) Configure system to apply standard 50% MSR reduction for unrelated procedures from different families; (3) Configure system to apply 50% reduction to non-endoscopic surgical procedures when billed with endoscopies; (4) Remove any logic that allows separate payment for base codes when more complex endoscopies from the same family are performed; (5) Test billing scenarios with multiple endoscopies to validate correct reductions before the effective date; (6) Train billing and coding staff on the new rules and communicate changes to ASC providers. Failure to implement these changes will result in incorrect claim submissions and potential overpayments requiring adjustment.