An ambulatory surgical center (ASC) is a distinct entity that exclusively provides surgical services not requiring an overnight stay. An ASC might be hospital-based or free-standing. Procedures performed in an ASC may be elective or medically necessary and may be paid for in a variety of ways including private pay, insurance, and Medicare. Medicare has specific requirements in order for an ASC to receive payment from Medicare. The extensive requirements specify standards for anesthesia administration, operating room, quality measures, and medical and nursing staff. State licensure and accreditation requirements vary somewhat geographically. Medicare reimburses ASC procedures by the “bundles” of services provided, and the reimbursement is usually higher than Medicare pays for the same procedures in settings such as a hospital outpatient setting. Anti-referral laws do not apply to ASCs as they do to other facilities, so physicians may have joint ownership in an ASC, refer payment, and perform the surgery. For these reasons, ASCs have grown rapidly in number. Patients find ASCs attractive because of more convenient locations, ease of scheduling procedures, and shorter wait times for procedures as compared to other settings.

Contributed By:

Glen McDaniel, MS, MBA
President and Chief Executive Officer
GM Global