How is the fee schedule calculation determined for Ambulatory Surgical Centers (ASCs)?
A8. The payment rates established for the groups of ASC procedures are standard base rates that have been adjusted to remove the effects of regional wage variations. When the carrier process claims for ASC facility services, they adjust the base rates to reflect the wage index value applicable to the area in which the ASC is located. The Medicare payment for ASC facility services is equal to 80 percent of the wage-adjusted standard payment rate. Beneficiaries are responsible for the Medicare co-payment for ASC facility services once their deductible is satisfied. The wage index includes the wage and salary levels of certain health care professionals in both urban and non-urban locations. Each MSA within a State has a separate index, and there is one index for all rural areas within a State. Also, each group’s payment rate has a labor and a non-labor component, and only the labor component is adjusted for the wage index.
Related Questions
- How do ancillary providers (skilled nursing facilities, ambulatory surgical centers, durable medical equipment suppliers, urgent care centers, etc.) join CHN?
- How should Ambulatory Surgical Centers (ASCs) report bilateral procedures under the revised ASC payment system?
- How will free-standing Ambulatory Surgical Centers (ASCs) be reimbursed?
