Ambulatory Surgical Center (ASC) Facility: Services Included in Payments
Published 05/29/2020
Ambulatory surgical center (ASC) services are those surgical procedures that are identified by the Centers for Medicare & Medicaid Services (CMS) on an annually updated ASC listing. Medicare makes a single payment to ASCs for covered surgical procedures, including ASC facility services furnished in connection with the covered procedure. Examples of covered ASC facility services paid through the ASC payment for covered surgical procedures include:
- Nursing services, services furnished by technical personnel and other related services
- Use of ASC facility including operating and recovery rooms
- Administrative, recordkeeping, and housekeeping items and services
- Drugs and biologicals when separate payment is not made under the Outpatient Prospective Payment System (OPPS), surgical dressings, supplies, splints, casts, surgical dressings, appliances and equipment
- Materials for anesthesia
- Blood, blood plasma, and platelets (except those for which the blood deductible applies)
- Implantable devices, with the exception of devices with pass-through status under the OPPS
- Radiology services for which payment is packaged under the OPPs
- Intraocular lenses (IOLs)
References
- Ambulatory Surgical Center (ASC) Payment CMS web page for a listing of covered procedures
- CMS Medicare Benefit Policy Manual (PDF) (Pub. 100-02), chapter 15, sections 260.2 and 260.4
- CMS Medicare Claims Processing Manual (PDF) (Pub. 100-04), chapter 14
- ASC Regulations and Notices