ASC Billing Services

ASC Billing Services

Ambulatory surgery centers face complex billing requirements for outpatient surgical procedures while often operating with limited administrative resources. MBW RCM’s ASC billing services help surgery centers streamline billing operations, stay aligned with evolving coding standards, and maintain compliance with CMS guidelines.

Key Components of ASC Billing Services

We follow structured billing workflows to support accurate outpatient surgical reimbursement and payer compliance:

• APC / Payment Group Assignment: Procedures are grouped into Ambulatory Payment Classifications that determine reimbursement.
• Packaging & NCCI Compliance: Bundled services and edit pairs must be correctly identified to avoid denials.
• Modifier -51/-59/-RT/-LT: Modifiers distinguish multiple, distinct, or laterality-specific procedures.
• Device-Intensive Procedure Coding: Procedures involving significant device costs require specific coding and documentation.

ASC Facility Reimbursement Methodology

Ambulatory surgery centers are reimbursed under the Medicare ASC Payment System, where procedures are assigned to Ambulatory Payment Classifications (APCs). Total facility reimbursement combines the ASC payment rate, device/implant adjustments, and multiple procedure discounts — MBW RCM ensures accurate CPT coding and correct APC assignment to support proper reimbursement.

MBW RCM brings specialty-focused expertise to ASC billing — accurate APC assignment, packaging and NCCI compliance, and device-intensive procedure coding that has recovered $420K annually in denied claims for one ASC client.