Understanding the current trends on ASC Billing Services
                     UNDERSTANDING THE CURRENT TRENDS ON ASC 
BILLING SERVICES
The total healthcare expenditure has seen an exponential increase 
in recent years. Seeing this growth, the Centers for Medicare and 
Medicaid Services initiated new programs and payment systems 
that can help reduce overall costs while enabling physicians and 
healthcare providers to offer cost-effective care to their patients.
Over the years, the healthcare infrastructure has also seen an 
increase in outpatient procedures that were conducted in 
ambulatory surgical centers (ASCs). ASCs exclusively provide 
outpatient surgeries which are a same-day or 24hour stay, 
typically focusing on a small subcategory of regular procedures 
and treatments. This approach allows ASCs to reduce the overall 
costs of surgery and those linked with post-operative care while 
allowing healthcare providers to receive similar outcomes and 
ensure quality patient satisfaction
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Since the Affordable Care Act, reimbursements in ASCs have 
reduced approximately to 42%  as compared to hospitals for the 
same procedure. This has reduced the growth and extensive use of 
ASCs. In spite of these changes, the ASC sector still witnessed an 
increase in revenue by $24 billion with an annual growth rate of 
5%.
This welcomed a financial opportunity for many large practices, 
healthcare providers, and hospital systems in recent years.
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Here are a few trends in ASC Services that you should know
• Ambulatory Service Center billing is not actually centered on a 
specific medical specialty which means it doesn’t involve any 
specific types of procedures or diagnoses. Therefore, Ambulatory 
Surgery Center billing is completely different from any other type 
of physician or facility billing. Unlike other medical specialty billing, 
ASC billing companies do not require learning highly specialized 
guidelines or rules to ensure reimbursement for services.
• For ASC billing services, you will first have to qualify by adhering 
to a certain set of requirements and also have a written agreement 
with CMS. In order to pay for ASC services, the service must be 
stated as medically necessary but the medical procedure doesn’t 
have to be performed at an ASC as well. This call is completely 
given to both the provider and the patient.
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• Usually, ASC billing uses similar codes, regulations, billing systems, and 
many of the same billing and coding guidelines used by the medical 
industry. But what makes it so different is that its codes are done through a 
CMS-1500 claim form, not a facility claim form, unlike hospital billing that 
uses the UB-04 claim form while the practitioners and remaining outpatient 
providers use the CMS-1500 form. Think of Ambulatory Service Centers like 
a medical specialty combined into one. Outsource ambulatory surgical 
center medical billing services to stay updated with the latest regulations.
• With respect to the Total Knee Arthroplasty which became a part of the 
Medicare ASC-payable list for 2020, Medicare has assigned a specific code 
to it. It is called the “device-intensive indicator”. This will not offer any 
separate reimbursement for the implants utilized in the Total Knee 
Arthroplasty, Medicare will ensure it adds a portion of the device along with 
the complex TKA Medicare reimbursement charges.
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• While working with bundled payments for claims processes, it is 
recommended to work alongside providers to negotiate the terms of 
the contract. This can help receive a confirmation on whether one 
claim will include the professional, anesthesia, and surgery free while 
discussing the payment distribution as per documentation that is 
operationally efficient and comes with lesser billing complexities. It is 
a complex task since the payers wish to have all the services within 
the same claim and handling this might need some assistance. Hence 
outsourcing ASC billing services can be a good option.
• Billing procedures for ambulatory surgical centers depend on the 
type of facility chosen and the location of treatment. Payment for ASC 
services is based on HMSA’s eligible charge. This eligible charge for a 
covered service is one all-inclusive rate based on the highest 
Outpatient Surgical Procedure-Related Group category of the 
procedure code billed.
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Why outsource ASC billing?
Outsource Ambulatory Service Center billing service to 24/7 
Medical Billing Services to receive the most professional and 
certified team who ensures your billing system is always following 
the latest trends of the industry. ASC can be complex and we at 
24/7 Medical Billing Services would like to simplify it for you so 
that you can focus on your services while we handle your billing 
system.
Read more : 
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ABOUT US
• We are a medical billing company that offers ‘24/7 Medical Billing Services’ and 
support physicians, hospitals, medical institutions and group practices with our end to 
end medical billing solutions. We help you earn more revenue with our quick and 
affordable services. Our customized Revenue Cycle Management (RCM) solutions 
allow physicians to attract additional revenue and reduce administrative burden or 
losses.
• Our company was founded in 2005 and is now a leading organization of highly 
motivated and certified coders & billers in the US medical billing industry. Our current 
employee strength is 500+ and we have ambitious plans to grow more rapidly.
• As a leading Medical Billing Outsourcing Company we take care of the complete setup 
& enrolment in about one to four weeks time depending on the complexity of the 
project. We have certified trainers with 10+ years of experience to train the 
newcomers so they can get acquainted with the specialty jargons & stay updated with 
the recent coding developments.
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CONTACT US
24/7 Medical Billing Services
16192 Coastal Hwy,
Lewes, DE – 19958
USA
Phone no : 
+1 888-502-0537
Email Address :
[email protected] 
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