Do you handle ASC facility billing or just professional billing?

We offer both. We handle professional billing for surgeons in ASC settings, as well as ASC facility billing for the center itself. Many clients use us for both, which improves coordination and reduces billing conflicts.

How do you handle implant reimbursement for orthopedic cases?

We work with your clinical and administrative team to collect implant invoices at time of surgery and include the invoice documentation required by each payer — ensuring implant costs are billed and tracked through to payment.

What is the process for Medicare ASC procedure verification?

We verify that each scheduled procedure is on the Medicare ASC covered procedure list before the case. For procedures that aren't covered in the ASC setting, we advise on financial counseling and alternative billing approaches.

How do you coordinate professional and facility billing for the same case?

When we're handling both, we coordinate claim submission timing and coding to ensure the facility and professional claims are consistent and don't create conflict or confusion at the payer level.

Do you monitor payments against ASC contract rates?

Yes. We track payment against contracted ASC rates for each payer — identifying short payments and underpayments and pursuing corrections when payers don't reimburse according to contract.

Specialty Billing

Ambulatory Surgery Center Billing

Specialized billing for ambulatory surgery centers — maximizing reimbursement for facility and professional services across all surgical specialties.

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ASC Billing Overview

Ambulatory surgery centers operate at the intersection of facility billing and professional billing — creating a complex billing environment that requires expertise on both sides to ensure complete reimbursement. ASC facility claims use APC (Ambulatory Payment Classifications) under Medicare, while commercial payers apply their own ASC fee schedules, which vary considerably across payers. At 2 Lee's Billing, we support both ASC facility billing and professional billing for surgeons and anesthesiologists performing procedures in ASC settings. Our team understands the unique requirements of ASC claims — including implant invoice submission, anesthesia billing coordination, and the specific documentation requirements that support facility reimbursement.

Coding Highlights

✓ASC facility claims — CMS-1500 vs. UB-04 submission rules
✓APC coding for Medicare ASC procedures
✓Implant cost reporting and invoice documentation
✓Anesthesia billing: base units + time units
✓Modifier AS (assistant surgeon) billing
✓Multiple procedure payment reduction rules
✓Place of service 24 (ASC) coding requirements

Common ASC Billing Challenges

Facility vs. Professional Claim Coordination

ASC facility claims and surgeon professional claims must be coordinated carefully to prevent billing conflicts, duplicate submissions, and payer mismatches that create delays and denials.

Implant Cost Reimbursement

High-cost implants — orthopedic hardware, stents, neurostimulators — are reimbursed separately from the base ASC facility rate, but require invoice documentation that must be submitted correctly and on time.

Payer Contract Complexity

Each commercial payer has its own ASC fee schedule and contract terms. Ensuring claims are billed and paid per contract requires ongoing payer-specific billing knowledge.

Prior Authorization

Most scheduled ASC procedures require prior authorization from commercial payers. A single missed authorization on a high-value surgical case represents substantial revenue loss.

Anesthesia Billing Coordination

When anesthesia is provided by a CRNAs or anesthesiologists, their billing must be coordinated with the facility claim to prevent patient balance confusion and claim conflicts.

Medicare ASC Covered Procedure List

Medicare only covers a defined list of procedures in the ASC setting. Procedures performed outside the covered list may not be reimbursable from Medicare — requiring upfront patient financial counseling.

How 2 Lee's Billing Supports ASC Practices

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ASC Facility Billing

We submit ASC facility claims with the correct procedure codes, place of service, and supporting documentation — ensuring clean submission and prompt payment for facility services.

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Professional Billing for ASC Surgeons

We handle professional billing for surgeons and other providers performing procedures at your ASC — with correct POS 24 coding and coordination with facility claims.

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Implant Documentation Management

We collect and submit implant invoices with surgical claims — meeting each payer's documentation requirements to ensure implant costs are properly reimbursed.

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Prior Authorization

We identify and obtain prior authorizations for all scheduled ASC cases — preventing authorization denials on high-value surgical claims.

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Payer Contract Monitoring

We monitor payments against contracted rates for each payer — identifying underpayments, short payments, and contract compliance issues.

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Denial Appeals

ASC denials — including medical necessity denials, authorization issues, and procedure-specific denials — are reviewed and appealed with supporting documentation.

ASC Billing FAQs

Related Services

Medical Billing & Coding Denial Management Credentialing & Enrollment Revenue Cycle Management

Other Specialties

General Surgery Orthopedics Gastroenterology Pain Management

ASC Billing Is Complex — Partner With Specialists

Get a free assessment of your ASC billing and find out how we can improve your facility and professional reimbursement.

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Or call us: (702) 478-8115 · Toll Free: (800) 364-1801