{"id":8708,"date":"2019-05-16T14:06:33","date_gmt":"2019-05-16T08:36:33","guid":{"rendered":"https:\/\/www.medicalbillersandcoders.com\/blog\/?p=8708"},"modified":"2025-05-12T09:24:05","modified_gmt":"2025-05-12T09:24:05","slug":"understand-payment-rates-and-basics-of-asc-billing","status":"publish","type":"post","link":"https:\/\/www.medicalbillersandcoders.com\/blog\/understand-payment-rates-and-basics-of-asc-billing\/","title":{"rendered":"Understand Payment Rates and Basics of ASC Billing"},"content":{"rendered":"<h2>Basics of ASC Billing<\/h2>\n<p style=\"text-align: justify;\">The Basics of ASC billing encompass the financial processes associated with Ambulatory Surgical Centers (ASCs). CMS defines an Ambulatory Surgical Center (ASC) as a facility that provides outpatient surgical services to patients. ASC is a facility that, very simply, specializes in outpatient procedures. Procedures at an ASC are more extensive than those at the typical provider&#8217;s office but are not so involved that they require a hospital stay. The basics of ASC billing (Ambulatory Surgery Center) are completely different from any other billing type. For ASC services to be paid, the service must be determined to be medically necessary. Generally, there are two primary elements in the total cost of performing a surgical procedure:<\/p>\n<ul style=\"text-align: justify;\">\n<li>The cost of the physician\u2019s professional services for performing the procedure<\/li>\n<li>The cost of services furnished by the facility where the procedure is performed (e.g., surgical supplies, equipment, and nursing services).<\/li>\n<\/ul>\n<h2>Basics of ASC Billing<strong> CPT Codes:<\/strong><\/h2>\n<ul>\n<li>99211: Evaluation and Management (E\/M) service for an established patient, typically used for minimal services such as administrative tasks.<\/li>\n<li>G0328: Colorectal cancer screening; fecal occult blood test, immunoassay, 1-3 simultaneous<\/li>\n<li>G0105: Colorectal cancer screening; colonoscopy on individual at high risk<\/li>\n<\/ul>\n<p style=\"text-align: justify;\">In general, the Medicare program pays ASCs 80 percent of the lesser of the actual charge or the ASC facility payment rate for the covered services performed. The beneficiary pays 20 percent of the lesser of the submitted charge or the ASC facility payment rate for the covered services performed. Payment rates for most services are geographically adjusted using the pre-reclassification wage index values that CMS uses to pay non-acute providers. The adjustment for geographic wage variation will be made based on a 50 percent labor-related share.<\/p>\n<p style=\"text-align: justify;\">Ambulatory surgical center claims are filed to Medicare, Medicare Advantage Plans, and Medicaid on an HCFA 1500 or the 837P. This differs from hospital outpatient surgery claims to the payers, filed on the UB-04 or the 837I. The CMS-1500 is the red-ink on white paper standard claim form used by physicians and suppliers for claim billing.<\/p>\n<p style=\"text-align: justify;\">Any non-institutional provider and supplier can use the CMS-1500 to bill medical claims. The electronic version of the CMS-1500 is called the 837-P, the P standing for the professional format. ASCs file medical claims to all other payers using the UB-04 or 837-I. When submitting claims on a UB-04, the revenue code used to report ambulatory surgical center procedures is 490.<\/p>\n<p style=\"text-align: justify;\">While ASC claims have some similarities to hospital claims regarding billing, there are some distinct differences. When submitting claims on the UB-04, the bill type for ASC claims is 83X. The first digit refers to the type of facility: 8 &#8211; Specialty Facility, Hospital ASC Surgery The second digit refers to the bill classification: 3 \u2013 Outpatient. The third digit refers to the frequency represented above by the variable X. 1 &#8211; Admit through discharge claim; 7 &#8211; Replacement of prior or corrected claim; 8 &#8211; Void or cancel of a prior claim.<\/p>\n<h2 style=\"text-align: center;\">Outsourcing your <a href=\"https:\/\/www.medicalbillersandcoders.com\/speciality\/ambulatory-surgical-centers-medical-billing-services.html\">ASC billing<\/a> to Medical Billers and Coders<\/h2>\n<h2 style=\"text-align: left;\">Examples of Covered ASC Facility Services are:<\/h2>\n<p>The basics of ASC billing aren\u2019t hard to master, but they differ from physician and facility requirements. The following overview will help you understand what\u2019s most important in this setting.<\/p>\n<ul style=\"text-align: justify;\">\n<li style=\"text-align: left;\">Nursing services, technical personnel furnished services, and other related services<\/li>\n<li style=\"text-align: left;\">Drugs and biologicals for which Medicare makes no OPPS separate payment; surgical dressings; supplies; splints; casts; appliances; and equipment<\/li>\n<li style=\"text-align: left;\">Administrative, recordkeeping, and housekeeping items and services<\/li>\n<li style=\"text-align: left;\">Blood, blood plasma, and platelets, except when the blood deductible applies<\/li>\n<li style=\"text-align: left;\">Materials for anesthesia<\/li>\n<li style=\"text-align: left;\">Intraocular lenses<\/li>\n<li style=\"text-align: left;\">Implantable devices, except devices with OPPS pass-through status<\/li>\n<li style=\"text-align: left;\">OPPS-packaged radiology services<\/li>\n<\/ul>\n<p style=\"text-align: justify;\">Medicare pays ASCs separately for covered ancillary services integral to a covered surgical procedure, such as certain services furnished immediately before, during, or immediately after the procedure.<\/p>\n<h3 style=\"text-align: left;\">Covered ancillary services include:<\/h3>\n<ul style=\"text-align: justify;\">\n<li style=\"text-align: left;\">Certain drugs and biological<\/li>\n<li style=\"text-align: left;\">Radiology services integral to the surgical procedure<\/li>\n<li style=\"text-align: left;\">Brachytherapy sources<\/li>\n<li style=\"text-align: left;\">Implantable pass-through status devices<\/li>\n<li style=\"text-align: left;\">Corneal tissue acquisition<\/li>\n<\/ul>\n<h2 style=\"text-align: left;\">Payment Rates:<\/h2>\n<p style=\"text-align: justify;\">CMS sets annual ASC Payment System updates using relative payment weights equal to OPPS relative payment weights for the same services and then scales the ASC weights to maintain budget neutrality from year to year. CMS scales ASC relative payment weights to eliminate any difference in the total payment weight between the current and upcoming CY by:<\/p>\n<ul style=\"text-align: justify;\">\n<li style=\"text-align: left;\">Holding ASC use and mix of services constant from the most recent full-year claims data available<\/li>\n<li style=\"text-align: left;\">Comparing the covered ASC surgical procedures and separately payable ancillary service&#8217;s total payment weight using the current CY\u2019s ASC relative payment weights to the total payment weight using the applicable upcoming CY OPPS relative payment weights<\/li>\n<\/ul>\n<p style=\"text-align: justify;\">The ratio of the current CY to the upcoming CY total payment weight is the weighted scalar. It is applied to the upcoming CY relative payment weights to maintain budget neutrality. CMS annually adjusts the ASC conversion factor (CF) for budget neutrality by removing the effects of changes in wage index values for the upcoming year compared to the current year and makes a productivity adjustment. The productivity adjustment reduces the ASC Payment System annual update factor.<\/p>\n<p style=\"text-align: justify;\">Another update factor was absent in the past, so CMS updated the ASC CF using the Consumer Price Index for All Urban (CPI-U) Consumers. However, from 2019 through 2023, CMS will update the ASC payment system using the hospital market basket update. ASCs receive less than the actual charge or the ASC payment rate for each procedure or service. CMS sets the standard payment rate for ASC-covered surgical procedures using the ASC CF and the ASC relative payment weight product for each separately payable procedure or service.<\/p>\n<p style=\"text-align: justify;\">CMS establishes alternate payment methods for office-based procedures, device-intensive procedures, covered ancillary radiology services, and drugs and biologicals. CMS makes a geographic payment adjustment to covered surgical procedures and certain covered ancillary services using the pre-floor and pre-reclassified hospital wage index values, with a labor-related factor of 50 percent.<\/p>\n<p style=\"text-align: justify;\"><a href=\"https:\/\/www.cms.gov\/\"><strong>CMS<\/strong><\/a> makes an additional adjustment when the ASC furnishes multiple surgical procedures in the same encounter or when ASC personnel discontinue procedures before initiating or administering anesthesia.<\/p>\n<p style=\"text-align: left;\">The following table provides information on alternate methods to establish payment rates for some surgical procedures and ancillary services:<\/p>\n<table style=\"width: 96.9701%; height: 485px;\" width=\"1054\">\n<tbody>\n<tr style=\"height: 56px;\">\n<td style=\"height: 56px; border-style: solid; border-color: #000000;\" width=\"488\"><span style=\"font-size: 14pt;\"><b>Surgical Procedure\/Ancillary Service<\/b><\/span><\/td>\n<td style=\"height: 56px; border-style: solid; border-color: #000000;\" width=\"566\"><span style=\"font-size: 14pt;\"><b>Payment Method<\/b><\/span><\/td>\n<\/tr>\n<tr style=\"height: 104px;\">\n<td style=\"height: 104px; border-style: solid; border-color: #000000;\" width=\"488\">Office-Based Procedures in Physicians&#8217; Offices at Least 50 Percent of the Time that CMS Classifies &#8220;Office-Based.&#8221;<\/td>\n<td style=\"height: 104px; border-style: solid; border-color: #000000;\" width=\"566\">Paid at the lower of the ASC rate or the non-facility practice expense (PE) relative value unit (RVU), the amount of the Medicare Physician Fee Schedule (PFS) for the relevant year.<\/td>\n<\/tr>\n<tr style=\"height: 104px;\">\n<td style=\"height: 104px; border-style: solid; border-color: #000000;\" width=\"488\">Device-Intensive\u00a0\u00a0\u00a0\u00a0 Procedures\u00a0\u00a0\u00a0\u00a0 (ASC-Covered\u00a0\u00a0\u00a0\u00a0 Surgical Procedures When the Estimated Device Offset Percentage Is\u00a0 Greater\u00a0 Than\u00a0 30\u00a0 Percent\u00a0 of\u00a0 the\u00a0 HCPCS\u00a0 Code&#8217;s\u00a0 Mean Cost)<\/td>\n<td style=\"height: 104px; border-style: solid; border-color: #000000;\" width=\"566\">It is paid with the device-related portion of the procedure (Medicare pays an ASC and OPPS the same amount) and a service portion (calculated according to the standard rate-setting method).<\/td>\n<\/tr>\n<tr style=\"height: 80px;\">\n<td style=\"height: 80px; border-style: solid; border-color: #000000;\" width=\"488\">Separately\u00a0 Payable\u00a0 Covered\u00a0 Ancillary\u00a0 Radiology\u00a0 Services Facility Costs<\/td>\n<td style=\"height: 80px; border-style: solid; border-color: #000000;\" width=\"566\">It is paid at the lower ASC rate, the technical component, the non-facility PE RVU, and the amount of the Medicare PFS for the same year (whichever applies).<\/td>\n<\/tr>\n<tr style=\"height: 56px;\">\n<td style=\"height: 56px; border-style: solid; border-color: #000000;\" width=\"488\">Separately Payable OPPS Drugs and Biologicals<\/td>\n<td style=\"height: 56px; border-style: solid; border-color: #000000;\" width=\"566\">Paid at the same amount as OPPS<\/td>\n<\/tr>\n<tr style=\"height: 104px;\">\n<td style=\"height: 104px; border-style: solid; border-color: #000000;\" width=\"488\">Brachytherapy Sources<\/td>\n<td style=\"height: 104px; border-style: solid; border-color: #000000;\" width=\"566\">Medicare pays at the same rate as OPPS rates if a prospective OPPS rate is available. Otherwise, Medicare pays at contractor-priced rates. There is no payment adjustment for geographic wage differences.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p>To learn more about how <strong>Medical Billers and Coders<\/strong> can be a value-adding billing partner for your practice, email us at <a href=\"mailto:info@medicalbillersandcoders.com\">info@medicalbillersandcoders.com<\/a> or <a href=\"tel:888-357-3226\"><strong>888-357-3226<\/strong><\/a>.<\/p>\n<p><\/p>\n<p><strong>Source:<\/strong><\/p>\n<p> <\/p>\n<p><a href=\"https:\/\/www.cms.gov\/medicare\/payment\/prospective-payment-systems\/ambulatory-surgical-center-asc\">AMBULATORY SURGICAL CENTER PAYMENT SYSTEM<\/a><\/p>\n<p><\/p>\n<h2><strong>FAQs<\/strong><\/h2>\n\n\n<div class=\"schema-faq wp-block-yoast-faq-block\"><div class=\"schema-faq-section\" id=\"faq-question-1747041692729\"><strong class=\"schema-faq-question\"><strong>What are ASCs and why are they important in healthcare billing?<\/strong><\/strong> <p class=\"schema-faq-answer\">ASCs are outpatient surgical centers that play a crucial role in providing cost-effective surgical care outside traditional hospital settings, impacting healthcare billing significantly.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1747041718580\"><strong class=\"schema-faq-question\"><strong>What factors influence payment rates for procedures performed in ASCs?<\/strong><\/strong> <p class=\"schema-faq-answer\">Payment rates for ASC procedures are influenced by factors such as procedure complexity, geographic location, payer contracts, Medicare reimbursement guidelines, and specific ASC services.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1747041739869\"><strong class=\"schema-faq-question\"><strong>How do payment rates for ASC procedures compare to those in hospital settings?<\/strong><\/strong> <p class=\"schema-faq-answer\">ASC payment rates are typically lower than those in hospital settings due to lower overhead costs and streamlined outpatient care services.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1747041750173\"><strong class=\"schema-faq-question\"><strong>What are some common challenges in ASC billing and reimbursement?<\/strong><\/strong> <p class=\"schema-faq-answer\">Common challenges include navigating complex payer policies, ensuring accurate coding and documentation, managing revenue cycle processes efficiently, and staying updated with regulatory requirements.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1747041763646\"><strong class=\"schema-faq-question\"><strong>What are some key billing codes and terminology relevant to ASC billing?<\/strong><\/strong> <p class=\"schema-faq-answer\">Key codes and terminology include CPT codes for procedures, HCPCS codes for supplies\/services, modifiers for special circumstances, and ICD-10 diagnosis codes.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1747041780275\"><strong class=\"schema-faq-question\"><strong>How can healthcare providers optimize ASC billing practices for maximum reimbursement?<\/strong><\/strong> <p class=\"schema-faq-answer\">Providers can optimize billing by implementing effective revenue cycle management strategies, conducting regular audits, leveraging technology, negotiating favorable contracts, and staying informed about industry trends.<\/p> <\/div> <div class=\"schema-faq-section\" id=\"faq-question-1747041795838\"><strong class=\"schema-faq-question\"><strong>What resources are available for learning more about ASC billing and payment rates?<\/strong><\/strong> <p class=\"schema-faq-answer\">Resources include educational programs, industry publications, webinars, professional associations, consulting services, CMS guidelines, and continuing education opportunities.<\/p> <\/div> <\/div>\n\n\n\n<p><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Basics of ASC Billing The Basics of ASC billing encompass the financial processes associated with Ambulatory Surgical Centers (ASCs). CMS defines an Ambulatory Surgical Center (ASC) as a facility that provides outpatient surgical services to patients. ASC is a facility that, very simply, specializes in outpatient procedures. Procedures at an ASC are more extensive than [&hellip;]<\/p>\n","protected":false},"author":2,"featured_media":8709,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[662],"tags":[862,3922,914,743,1295,782,4738,4740,4739,3921,4737,4742,117,4741],"class_list":["post-8708","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-ambulatory-surgical-centers","tag-ambulatory-surgical-center","tag-ambulatory-surgical-center-payment-systems","tag-ambulatory-surgical-centers-2","tag-ambulatory-surgical-centers-billing","tag-ambulatory-surgical-centers-billing-company","tag-asc-billing","tag-asc-billing-and-payment-rates","tag-asc-billing-and-reimbursement","tag-asc-billing-practices","tag-asc-facility-services","tag-basics-of-asc-billing","tag-basics-of-asc-billing-cpt-codes","tag-medical-billers-and-coders-2","tag-outsourcing-your-asc-billing"],"yoast_head":"<!-- This site is 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