decisionhealth Newsletters, Answer Books - 2009 Issue 2 (February)
Ambulatory Surgery Centers / ASC payment rates vary by locality
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Article Overview
This short article describes Medicare’s approach to setting ambulatory surgery center reimbursement levels and adjusting those rates for local wage variation. It is relevant to ASC billing and coding professionals, revenue cycle staff, and others who need a general understanding of how facility payment is localized under Medicare Part B. The article also notes related beneficiary cost-sharing considerations and a specific exception to wage adjustment.
Why This Topic Matters
Understanding how ASC facility payment is localized helps readers interpret Medicare reimbursement at a high level and recognize why payments can differ by geography.
What You Will Learn
- How Medicare establishes ambulatory surgery center payment rates
- How local wage levels affect ASC reimbursement
- What general Medicare Part B cost-sharing applies to ASC facility services
- That certain payment amounts may not be subject to wage adjustment
Who Should Read This
- ASC administrators
- Medical coders
- Billing specialists
- Revenue cycle staff
- Healthcare reimbursement professionals
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