Transcure Responds to CMS Removal of 285 Inpatient-Only Procedures
The Californer/10340273

ORANGE, Calif. - Californer -- Transcure, a premier revenue cycle management firm, has announced the implementation of new billing protocols for California surgery centers following the recent decision by Centers for Medicare & Medicaid Services (CMS) to remove 285 procedures from the Inpatient-Only (IPO) list. This regulatory shift enables a wide range of complex musculoskeletal and cardiovascular procedures to be performed in outpatient settings.

As an established ASC billing service provider in California, Transcure is guiding its clients through this significant transition. The removal of these codes marks the first phase of CMS's three-year plan to eliminate IPO list by 2029. California facilities must now revise their site-of-service decision pathways.

"The phase-out of the IPO list represents a monumental shift for independent surgical centers," said Ali Nadeem, CEO of Transcure. "Our role is to ensure that these facilities have administrative infrastructure to match their clinical ambitions. By refining our coding protocols for these 285 procedures, we are protecting financial health of clinics as they take on more complex patient cases."

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Adapting to Musculoskeletal and Cardiovascular Shifts

The 285 removed procedures primarily involve orthopedics and interventional cardiology, including complex spinal fusions, hip arthrodesis, and selected heart valve repairs. Previously restricted to hospital settings, these procedures can now be performed in independent surgery centers for Medicare beneficiaries. Transcure's certified coders are applying their extensive California market experience to ensure full compliance with outpatient reimbursement requirements.

Managing the Two-Midnight Rule Exemptions

To support this transition, CMS finalized a policy exempting these 285 procedures from medical review activities. For 2026, these cases are protected from patient-status denials tied to the two-midnight rule.

"While two-midnight rule exemption provides a necessary safety net, it is not a license for loose documentation," noted Faran Ali, VP of Growth at Transcure. "Payer scrutiny remains high. We are working with our California partners to ensure every operative report clearly justifies the outpatient setting."

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Capturing the Full Cost of Surgical Implants

Many newly eligible procedures involve costly surgical implants and hardware. In ASC settings, proper application of device pass-through rules and accurate HCPCS coding is essential. Transcure's "Line-Item Scrubbing" process verifies every implant is linked to the correct code before claim submission.

Supporting Independent Surgical Excellence

Independent surgery centers play a vital role in delivering high-quality care. Transcure provides real-time financial dashboards that track net collection rates and reimbursement trends for added CPT codes. With over 1,100 certified professionals managing 5 million claims annually, Transcure ensures compliance while enabling surgeons to focus on patient care.

About Transcure

Founded in 2002, Transcure is a leading medical billing services and revenue cycle management company serving 40 specialties nationwide. The company is HIPAA-compliant, ISO 27001 certified, and supports more than 500 physicians across United States.