Goto Medical Management Associates, Inc. Home page. Medical Management Associates - Ask A Consultant - Billing Office-based Surgery Facility Fees

Date: 11/18/2002

Q:

Can you please provide me with information required, or orient me to the proper channels to be able to bill for (office-based surgery) facility fee?
Related Topics
ASC Services
Physician Credentialing
Surgery Center Feasibility
Billing Facility/Office-based Surgery Fees
Surgery Center Certification
ASC-Endoscopy Center Revenue Codes

A:

In most states, approval from a health planning agency or other similar state agency is required as a pre-requisite to applying for a license to operate an ambulatory surgery center. To obtain reimbursement for a facility fee from various third party payors, the facility must meet or exceed the specific criteria required by the third party payor. The criteria will vary by carrier, however, most carriers will require either state licensure, Medicare certification and/or accreditation. You should contact the insurance carriers and determine their specific requirements.
 

Edward C. Luke, Jr.
Senior Associate

MMA does not provide legal, accounting, or tax advice.  If you need assistance in these areas, we recommend that you consult a qualified professional.  In addition, please note that a client relationship with MMA is not established by the submission of a question to this forum or by the publishing of MMA's response.

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