Physicians’ Services – This category includes the most covered services in ASCs that are not regarded as ASC services. Physicians who provide services in ASCs may invoice for and obtain separate payment under Part B. Anesthesiologists administrating or monitoring the management of anesthesia to beneficiaries in ASCs and the beneficiaries’ healing from anesthesia are among the services provided by physicians. Physicians’ solutions have included routine pre-or post-operative services, such as doctor’s visits, consultations, screening procedures, stitch removal, dressing changes, and other services that the personal physician typically includes in the service charge for a given surgical operation.
Implantable Durable Medical Equipment (DME) – If the ASC provides patients with implantable DME, the ASC expenses and gets a single payment from the contract company for both the wrapped surgical operation and the surgically implanted device, as long as the implantable device does not have turn status under the OPPS. When major surgery is not on the ASC list, the physician expenses for their professional services and the ASC may invoice the beneficiary for facility charges.
Non-implantable Durable Medical Equipment – If the ASC provides non-implantable DME to recipients, it is handled as a DME supplier. The DME terms and regulations apply, including acquiring a supplier number and billing the beneficiary where applicable.
Prosthetic Devices –An ASC could bill and obtain separate payment for surgically implanted prosthetic devices other than intraocular lenses (IOLs) implanted, or otherwise adapted by the ASC list of acceptable procedures. The ASC charged the A/B MAC (B) and received the money under the DMEPOS fee schedule. However, the facility payment rate included an intraocular lens (IOL) implanted during or after cataract surgery in an ASC.
Ambulance Services – If the ASC provides ambulance services, the facility may be approved as an ambulance supplier to charge covered ambulance services.
Leg, arm, back, and neck braces – Like non-implantable prosthetic devices, these parts and components are covered under Part B but were not included in the ASC payment for ASC services. If the ASC provides these to recipients, it is handled as a supplier. It must follow all of the terms and regulations that apply to suppliers, including acquiring a provider number and billing the DME MAC.
Artificial legs, arms, and eyes – This equipment, like non-implantable prosthetic devices and braces, is not regarded as an ASC facility service and thus wasn’t included in ASC payment for ASC offerings. Suppose the ASC provides these items to beneficiaries. In that case, it is handled as a provider and must follow all of the terms and regulations that apply to suppliers, such as obtaining a provider number and invoicing the DME MAC.
Independent Laboratory Services –Only a restricted number and type of diagnostics are regarded as ASC facility services and are included in ASC payment for wrapped surgical procedures. Diagnostic tests conducted directly by an ASC are not regarded as ASC facility services and are not covered by Medicare in most situations.
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