Billing ASC - Implantable DME AND NON Implantable DME

Implantable DME

If the ASC furnishes items of implantable DME to patients, the ASC bills and receives a single payment from the local contractor for the covered surgical procedure and the implantable device, as long as the implantable device does not have pass-through status under OPPS. When the surgical procedure is not on the ASC list, the physician bills for his professional services and the ASC may bill the beneficiary for the facility charges associated with the procedure.

Non-Implantable DME
If the ASC furnishes items of non-implantable DME to beneficiaries, it is treated as a DME supplier and all the rules and conditions ordinarily applicable to DME are applicable, including obtaining a supplier number and billing the DME Medicare Administrative Contractor (MAC) where applicable.