Ambulatory Surgical Centers (ASCs) Tips and Reminders


Here are a few reminders about the payment of services performed in an ASC:

  • ASC services are reimbursed based on the ASC Fee Schedule (groups are no longer applicable)
  • Payment for some applicable drug (HCPCS J-codes) and ancillary services will be made. Some ancillary services must be submitted with HCPCS modifier TC (these codes are located on the Ambulatory Surgical Center (ASC) Payment CMS web page)
  • If a surgery is discontinued in an ASC prior to the administration of anesthesia, submit CPT modifier 73 and include documentation with the claim
  • If a surgery is discontinued after the administration of anesthesia, submit CPT modifier 74 and include documentation with the claim
  • For specified procedure codes that include payment for a device, include modifier FB on the procedure code when a specified device is furnished without cost or for which full credit is received
  • ASCs will be paid a reduced amount for certain procedures when they receive a partial credit for more than 50 percent of the cost of a medical device
    • Submit HCPCS modifier FC to report that you received a partial credit for more than 50 percent of the cost of the device
    • CMS provides Medicare contractors with a price for the other procedures with and without HCPCS modifier FC
  • Submit HCPCS modifiers LT and RT for bilateral procedures performed on the same date




Last Updated: 05/29/2020