Service performed in ASC but need claim seperately for billing

Services Furnished in an ASC Which Are Not ASC Facility Services

A single payment is made to an ASC, which includes all facility services furnished by the ASC in connection with a covered procedure. A number of items and services covered under Medicare may be furnished in an ASC, which are not considered facility services and that the ASC payment does not include.

The following are services not included in the ASC facility service:

• Physicians’ services (should be submitted by the physician).

• Physician payment for non-covered ASC procedures (should be submitted by the physician).

• Purchase or rental of non-implantable (DME to ASC patients for use in their home (should be submitted to
the DME MAC by the supplier).

• Implantable DME and accessories.

• Non-implantable prosthetic devices (should be submitted to the DME MAC by the supplier).

• Implantable prosthetic devices except certain intraocular lenses (IOLs and NTIOLs) and accessories.

• Ambulance services (should be submitted by the ambulance provider).

• Leg, arm, back and neck braces (should be submitted to the DME MAC by the supplier).

• Artificial legs, arms and eyes (should be submitted to the DME MAC by the supplier).

• Services furnished by an independent laboratory (should be submitted by the certified lab, or the ASC if the ASC has received lab certification and a CLIA number).

• Procedures not on the ASC list (should be submitted by the physician).