Outpatient Facility Coding Alert

Reader Question:

Pinpoint Which Services You Can Bill Separately

Question: I know that the facility fee includes many services we provide to patients in our ASC, but not everything. What things can we bill separately?
Washington Subscriber

Answer: You're correct in saying the maximum allowable facility fee includes many services that are inherent with a hospital stay (such as use of the facility, administrative functions, nursing and other staff care, and more). Fees for some other services are separately billable because they vary according to the patient's specific case. Separately billable services or supplies can include:

  • Services provided by physicians or other contracted professionals (including anesthesia)
  • Leg, arm, back, and neck custom braces
  • Artificial legs, arms, and eyes
  • Services furnished by an independent laboratory
  • The technical component of radiology services related to the surgery
  • Prosthetic devices that will be permanent replacements for existing body parts.



Your payers' policies on separately billable services might vary. Check for details before filing the claim.