Avoid common errors when billing procedures performed in ASC

Why This Topic Matters

ASC reimbursement can differ from office, hospital outpatient, and physician billing, so misunderstanding the setting or payment guidance can lead to claim errors or missed reimbursement. This topic matters to facilities and billing teams that need to keep pace with periodic CMS updates and payment policy changes.

Article Sections

1. ASC setting and claim form differences

   Introduces the ambulatory surgery center environment and outlines broad differences between hospital-based and freestanding ASCs for billing purposes.

2. Key reimbursement reminders

   Summarizes general payment update practices, fee schedule monitoring, and the role of ASC payment indicators in reimbursement workflows.

3. ASC fact sheet

   Describes CMS educational material that explains how ASC payment amounts are determined and addresses services not included in ASC payments.

4. Services not included in ASC payments

   Provides a broad overview of categories of items and services that are handled outside ASC facility payment and identifies where related billing is directed.