ASC Quality Reporting Program (ASCQR): measures, deadlines and penalty
Short answer
The ASC Quality Reporting Program is a CMS pay-for-reporting program. An ASC that misses its requirements gets a 2.0 percentage point cut to its Medicare annual payment update. Data for 2026 are due January 1 to May 17, 2027 and affect 2028 payment. OAS CAHPS survey data are due quarterly.
- Penalty
- 2.0 percentage point reduction in the annual payment update
- 2026 data affects
- Medicare payment from January 1 to December 31, 2028 (CY 2028 payment determination)
- Web-based measures due
- January 1 to May 17, 2027, for events in calendar year 2026
- OAS CAHPS Q2 2026 due
- October 14, 2026. Q3 is due January 13, 2027 and Q4 April 14, 2027
- Case-volume exemption
- Fewer than 240 Medicare claims a year (primary and secondary payer)
- Voluntary measures
- ASC-11 (cataract visual function) and ASC-21 (THA/TKA patient-reported outcome) for 2026
- Claims-based measures
- ASC-12, ASC-17, ASC-18 and ASC-19 come from Medicare claims. Nothing to submit
- Where to submit
- Hospital Quality Reporting (HQR) with a HARP account and a Security Official
Applies to: Medicare-participating ambulatory surgical centers paid under the ASC payment system · ASCs with at least 240 Medicare claims a year (primary and secondary payer)
What is the ASC Quality Reporting Program?
ASCQR is a CMS pay-for-reporting program set up by the Tax Relief and Health Care Act of 2006. It applies to ASCs paid under Medicare Part B fee-for-service that meet a claims threshold. CMS posts submitted data publicly after the ASC has had about 30 days to preview it.
The rules are at 42 CFR 416.300 through 416.320, and CMS changes the measure set each year in the OPPS/ASC payment rule. See the ASCQR glossary entry for a short definition.
What is the penalty for not reporting?
An ASC that misses program requirements gets a 2.0 percentage point cut to its annual Medicare payment update for that payment year. The statute is section 1833(i)(7) of the Social Security Act. The rule is 42 CFR 416.300(a). The cut applies to the facility's NPI, so every facility billing under that NPI is affected.
| Situation | Result |
|---|---|
| Required data not submitted, or a required measure left blank | 2.0 percentage point reduction for that payment determination year |
| ASC withdraws from the program (allowed through August 31 of the year before the payment determination) | 2.0 percentage point reduction for that year and each later year it stays withdrawn |
| Fewer than 240 Medicare claims in a year (primary and secondary payer) | Not required to report for the next period. For example, fewer than 240 claims in 2025 means no 2026 reporting |
| Extraordinary circumstance such as a hurricane | Request an exception within 60 calendar days. CMS may exempt the ASC or extend the deadline |
| Notified that you will not receive the full update | Reconsideration request due March 17 of the payment determination year |
To estimate what the cut means for your center, use the ASCQR penalty calculator.
Which measures apply to the 2026 reporting period?
CMS's January 2026 guide lists these measures for the CY 2026 reporting period, which sets the CY 2028 payment determination.
| Measure | How it is reported | Status |
|---|---|---|
| ASC-1 Patient Burn; ASC-2 Patient Fall; ASC-3 Wrong Site, Wrong Side, Wrong Patient, Wrong Procedure, Wrong Implant; ASC-4 All-Cause Hospital Transfer/Admission | Web-based, entered in HQR | Required |
| ASC-9 Appropriate Follow-Up Interval for Normal Colonoscopy in Average Risk Patients; ASC-13 Normothermia; ASC-14 Unplanned Anterior Vitrectomy | Web-based, entered in HQR | Required |
| ASC-11 Cataracts: Improvement in Patient's Visual Function within 90 Days | Web-based, entered in HQR | Voluntary |
| ASC-15a to ASC-15e OAS CAHPS patient experience survey | Through a CMS-approved survey vendor, quarterly | Required |
| ASC-12, ASC-17, ASC-18, ASC-19 hospital visit measures | Calculated from Medicare claims | Nothing to submit |
| ASC-21 Total Hip and Total Knee Arthroplasty patient-reported outcome measure | Submitted by the ASC (pre- and post-procedure data) | Voluntary for 2026 |
CMS finalized the removal of ASC-20 (COVID-19 vaccination coverage among healthcare personnel), ASC-22 and ASC-23 (social drivers of health) and ASC-24 (facility commitment to health equity) in the CY 2026 OPPS/ASC final rule.
What are the deadlines right now?
As checked on October 5, 2026, the next date is the Q2 2026 OAS CAHPS submission on October 14, 2026. HQR must accept submissions by 11:59 p.m. Pacific Time on the due date. CMS advises leaving at least 15 calendar days before a deadline to fix errors. Always confirm dates on QualityNet.
| Item | Period covered | Deadline |
|---|---|---|
| OAS CAHPS, Q1 2026 | January 1 to March 31, 2026 | July 8, 2026 (passed) |
| OAS CAHPS, Q2 2026 | April 1 to June 30, 2026 | October 14, 2026 |
| OAS CAHPS, Q3 2026 | July 1 to September 30, 2026 | January 13, 2027 |
| OAS CAHPS, Q4 2026 | October 1 to December 31, 2026 | April 14, 2027 |
| Web-based measures (ASC-1, -2, -3, -4, -9, -13, -14, and voluntary -11) | January 1 to December 31, 2026 | Submission window January 1 to May 17, 2027 |
| Claims-based measures | ASC-12: January 1, 2024 to December 31, 2026. ASC-17 to ASC-19: January 1, 2025 to December 31, 2026 | No submission |
Who must participate?
- ASCs paid under Medicare fee-for-service with at least 240 Medicare claims a year must participate. An ASC newly designated as open must be open in iQIES at least four months before data collection starts.
- ASCs that share one NPI report for all facilities under that NPI.
- Register a HARP account and name a Security Official in HQR. CMS recommends two. Log in at least every 60 days to keep an account active.
- Contract with a CMS-approved OAS CAHPS survey vendor.
Where do the adverse event numbers come from?
ASC-1 to ASC-4 are counts from your own records. For each you enter a numerator, such as ASC admissions with a burn before discharge, and a denominator of all ASC admissions. If you had no events, you still enter zeros. A blank required measure counts as not reporting.
Your incident log is the source of the numbers you attest to. An event filed under another category, or never entered, changes them. Reconcile the log against the measure definitions in the ASCQR Specifications Manual each quarter, not in April. The same data feeds your QAPI program, because 42 CFR 416.43 requires an ASC to track adverse patient events. See ASC QAPI requirements.
How to avoid a missed submission
- Name two Security OfficialsOne primary and one backup, both with active HQR logins.
- Calendar the datesThe four OAS CAHPS quarterly dates and the January to May window for web-based measures.
- Reconcile each quarterMatch incident log counts to the measure definitions and fix miscoded events early.
- Submit early and checkUse the submission requirements dashboard in HQR, and leave at least 15 calendar days to correct errors.
- Keep the recordFile the reconciliation sheet and a copy of what you submitted with your QAPI minutes.
How IncidentKit supports this requirement
| What the rule asks for | Where it lives in IncidentKit |
|---|---|
| ASC-1 to ASC-4 counts from your own records: burns, falls, wrong site, side, patient, procedure or implant, and hospital transfers | Intake captures each event once with its type, date and outcome. Analytics counts by type and period, so you can reconcile before you enter numbers in HQR. |
| Complete data, with zeros where there were no events | A pack sets incident types per site, so categories stay the same. A person still reviews the counts before submission. |
| Hospital transfer tracking (ASC-4 and the QAPI indicators surveyors look for) | Transfers to a hospital are recorded as incidents with the investigation attached. |
| QAPI: track adverse events, examine causes, sustain improvements (42 CFR 416.43) | Investigations lead to corrective actions with an effectiveness check. Compliance packets summarize the data for QAPI meetings. |
| Submitting data and running the patient survey | IncidentKit does not submit to HQR or run OAS CAHPS. Your Security Official enters the web-based data, and your survey vendor submits survey data. |
Product parts involved: Incident reporting, Analytics, Investigations and RCA, Corrective actions (CAPA), Compliance packets. Capabilities marked “rolling out” are being released in stages; see the changelog.
Frequently asked questions
How much is the ASCQR payment reduction?
2.0 percentage points off the annual Medicare payment update for the affected year. It applies to the NPI, so every facility under that NPI is affected.
What if we have no events to report for a measure?
Enter zeros, or choose the option confirming no data. Required measures cannot be left blank, and a blank brings the 2.0 percentage point reduction. ASC-11 is voluntary.
Can we withdraw from the program to avoid the work?
Yes, through August 31 of the year before a payment determination. But it triggers the 2.0 percentage point reduction for that year and each later year. ASCs with fewer than 240 Medicare claims are exempt without withdrawing.
What if a hurricane or other disaster stops us from reporting?
Request an extraordinary circumstances exception within 60 calendar days. CMS may exempt you, extend the time or grant a blanket exception to a region. Keep records of the event.
Does the ASC run the OAS CAHPS survey itself?
No. Use a CMS-approved OAS CAHPS vendor. An ASC with fewer than 60 survey-eligible patients in the period may request a participation exemption through December 31 of the reporting period.
Sources
- 42 CFR 416.300, basis and scope of the ASCQR Program (eCFR)
- 42 CFR 416.305, participation and withdrawal requirements (eCFR)
- 42 CFR 416.310, data collection and submission requirements (eCFR)
- CMS, Guide to Successful Reporting in the ASCQR Program, January 2026
- CMS, ASCQR Important Dates, CY 2026 Reporting Period / CY 2028 Payment Determination
- CMS, CY 2026 OPPS/ASC final rule and ASCQR Program highlights, January 2026
Reviewed against the sources above on Oct 5, 2026. Rules change: confirm current requirements with the issuing body or your counsel before relying on any summary.
Map this requirement to your records.
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