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Question: medicare pays for surgical procedures in an ambulatory surgery center...

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Medicare pays for surgical procedures in an Ambulatory Surgery Center (ASC) unless the Centers for Medicare & Medicaid Services (CMS) determines they are excluded for payment.


Respond to the following:
1. Identify one standard that must be met to qualify as a Medicare-certified ASC.
2. As it relates to ASC's, the Medicare payment equals what percentage of the total reimbursement for services provided?
3. As it relates to ASC's, Medicare beneficiaries are responsible what percentage of the total payment?
4. Which services are excluded from ASC payment?
5. What is the difference between ASC PPS and the Outpatient Prospective Payment System (OPPS)?

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