Ablations & ASC Coverage

On July 15, 2025, CMS released the proposed rule for outpatient hospital services and ambulatory surgical centers for 2026.  In the rule, CMS is proposing to add cardiac ablation procedures to the covered procedures list (PCL) for calendar year 2026. Heart Rhythm Advocates leveraged two years of prior HRS work in advocating for this important coverage change.  

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For the first time, CMS proposes adding several complex ablation procedures to the ASC Covered Procedures List (ASC-CPL), including:

 

• AV node ablation (CPT 93650)

• Atrial fibrillation ablation (CPT 93653)

• Ventricular tachycardia ablation (CPT 93654)

• Atrial flutter ablation (CPT 93656)

 

Other proposed additions include ICD lead removals (CPT 33244, 33272) and Category III CRT/conduction system pacing codes (0515T–0520T).

 

If finalized, these changes represent a major site-of-service shift for EP, moving procedures traditionally performed in hospital settings into ASCs. While this could expand access and reduce costs, it raises critical issues around patient safety, infrastructure readiness, and reimbursement sustainability.

 

CMS is accepting comments on the proposed rule until September 15, 2025. This is a pivotal opportunity for the EP community to weigh in on the clinical and financial implications of these changes.

 

We urge all EP physicians, administrators, and stakeholders to submit feedback to CMS through Regulations.gov.  Your voice is essential to ensuring that these policies protect patient safety, preserve clinical integrity, and sustain the future of electrophysiology care.