Practices Billing as ASCs

November 1, 2007

We’ve realized that ambulatory surgical centers (ASCs) get paid more than physician offices for some of the procedures we do. Our billers say we can just start billing as an ASC. I’m not so sure.

Question: We’ve realized that ambulatory surgical centers (ASCs) get paid more than physician offices for some of the procedures we do. Our billers say we can just start billing as an ASC. I’m not so sure.

Answer: Well, the definition of the ambulatory surgical center place-of-service code for CMS is “a freestanding facility, other than a physician’s office, where surgical and diagnostic services are provided on an ambulatory basis.” So it seems a little fishy to me.

Now, I’ve not had this issue come up before, so the billing team may truly have found some legitimate work-around, but I think it’s sure worth asking for proof.

My suggestion: Ask staff to justify their position. “Gosh, you know I really want to understand how this works. I see the definition is this. Please explain to me how we aren’t impacted by that. I’m really trying to expand my knowledge.”

See what you get and check it out.