Wiki Ambulatory Surgical Center what is the fee for physician?

[schanderson]

Good day all,

I do not know where to locate where the physician would be paid for services rendered in an ambulatory surgical center? The way I understand it is the Medicare Physician Fee Schedule for facility aka hospital has the the hashtag symbol and that is for hospital would it also mean the ambulatory center or is this located completely somewhere else.? I am so confused because I see a fee schedule for ambulatory surgical centers, but was told that is for what the facility gets not the physician. Some direction is needed in Michigan thank you.

 

[csperoni]

Let's think about why there are different fee schedules for some codes on facility vs non-facility. The intent is that it is realized when certain services are provided in a facility, the facility is incurring some expenses, and the physician does not need to supply certain items. Think of wound repair. If done in a facility, the facility is providing the suture material, gloves, gown, dressing and staff. These are all things the practice would have to pay for if done in office. So, the practice expense RVU is different to compensate for those things. Additionally, the facility will be submitting a bill to the insurance for the expenses they incurred. The physician work RVU is exactly the same regardless of location.
Once think about it that way, you realize an ASC is a facility. The ASC is submitting a bill. The ASC is providing a space to work, employees, and supplies.
If you are seeing a fee schedule for an ASC, that is the rate the ASC facility will be paid. You would look at the physician fee schedule. If the procedure is done in office, you receive non-facility reimbursement. If the procedure is done in an ASC, you receive facility reimbursement.
Hope that helps!

 

[schanderson]

Let's think about why there are different fee schedules for some codes on facility vs non-facility. The intent is that it is realized when certain services are provided in a facility, the facility is incurring some expenses, and the physician does not need to supply certain items. Think of wound repair. If done in a facility, the facility is providing the suture material, gloves, gown, dressing and staff. These are all things the practice would have to pay for if done in office. So, the practice expense RVU is different to compensate for those things. Additionally, the facility will be submitting a bill to the insurance for the expenses they incurred. The physician work RVU is exactly the same regardless of location.
Once think about it that way, you realize an ASC is a facility. The ASC is submitting a bill. The ASC is providing a space to work, employees, and supplies.
If you are seeing a fee schedule for an ASC, that is the rate the ASC facility will be paid. You would look at the physician fee schedule. If the procedure is done in office, you receive non-facility reimbursement. If the procedure is done in an ASC, you receive facility reimbursement.
Hope that helps!

I feel so dum,b right now, but it makes total sense my brain was trying to make it harder then what it actually is. Thanks for responding to an obvious answer that was elusive to me.