tci Medicare Compliance & Reimbursement - 2008 Issue 33

ASC Payment: CMS Confirms That Docs in ASCs Should Collect Facility Rate

In the past, Medicare paid ASCs the higher non-facility rate for non-covered procedures If you perform a non-covered service in an ASC, you'd probably expect to be penalized financially for the non-covered nature of the service. But that's just the opposite of how CMS was paying physicians -- until now. According to CMS Transmittal 1604, issued on Sept. 26, CMS changes its tune, now reimbursing physicians at the facility rate when they perform excluded procedures. "We believe it would be incongruous with the revised ASC payment system policies to pay the typically higher non-facility rate to physicians who furnish...

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