Are ASCs free to perform all Medicare procedures allowed in a hospital outpatient department (HOPD)?

• A. Yes
• B. No
• C. Only with special authorization
• D. Only for select procedures

Answer: (B)

Medicare restricts which procedures can be done in an Ambulatory Surgical Center. An ASC has its own set of procedures that are eligible for ASC payment, and not every procedure that Medicare allows in a hospital outpatient department (HOPD) is eligible for an ASC. Procedures must be on the ASC-eligible list and meet the facility’s capabilities for anesthesia, staffing, equipment, and postoperative care. If a procedure isn’t on that list, it’s generally limited to HOPD or inpatient settings and billed under hospital outpatient/inpatient rules. So ASCs are not free to perform all Medicare procedures allowed in an HOPD. To determine eligibility for a specific procedure, check the CMS ASC payment indicators and related guidance.