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The Commission announces a staff retirement and thanks Ms. Barbara Cheeseboro for her service. The full advisory may be accessed here. 
The Commission announces a staff promotion and congratulates Ms. Mackenzie Stites on her achievement. The full advisory may be accessed here. 
 Regulation 67-1602 has been amended to establish electronic payment systems as the default method of payment for temporary disability and reimbursement for expenses. The full advisory and text of the regulation may be accessed here. 
The Commission has issued an advisory notice regarding changes to a procedure code in the 2024 MSPM. The full advisory may be accessed here. 
 

Ambulatory Surgical Center

Effective April 15, 2013, the Maximum Allowable Payment (MAP) for procedures performed in an Ambulatory Surgery Center will be calculated at 140% of the Medicare Payment for procedures plus the total cost of all surgical implants per case with Revenue Codes 274, 276, and 278 minus a five hundred ($500) implant cost reduction per case.  Ambulatory Surgery Centers are to utilize the “UB04” for all facility billing.

Revision Notice: Commission Amends Fee Schedule for Ambulatory Surgery Centers Surgically Implanted Devices (PDF) Ambulatory Surgery Center Fee Schedule for Surgically Implanted Devices Effective April 15, 2013. 

 

Claims for ambulatory surgery center services are paid at the Medicare national payment rate found at www.cms.gov/ASCPayment plus 40%.

Note: The multiple procedures rule still applies, and the National Correct Coding Initiative will be utilized in order to determine the appropriate billing of CPT and HCPCS codes.