Bilateral procedures under ASC PPS are reimbursed at what percentage of the payment rate?

Bilateral procedures under ASC PPS are reimbursed at what percentage of the payment rate?

• A. 50%
• B. 100%
• C. 200%
• D. 150%

Answer: (D)

Under the Ambulatory Surgical Center (ASC) Payment System (PPS), bilateral procedures are reimbursed at 150% of the payment rate. This means that when a patient undergoes a procedure on both sides of the body (bilateral), the ASC receives a higher reimbursement to account for the additional resources and services provided. The rationale behind this increased payment rate is to recognize that performing a procedure bilaterally typically involves more extensive time and resources, which justifies the additional reimbursement. In this context, receiving 150% of the single procedure payment rate ensures that ASCs are fairly compensated while still providing the necessary care to patients undergoing such procedures. Other options do not align with the established reimbursement guidelines under the ASC PPS; therefore, they do not accurately reflect the compensation structure for bilateral procedures.

Under the Ambulatory Surgical Center (ASC) Payment System (PPS), bilateral procedures are reimbursed at 150% of the payment rate. This means that when a patient undergoes a procedure on both sides of the body (bilateral), the ASC receives a higher reimbursement to account for the additional resources and services provided.

The rationale behind this increased payment rate is to recognize that performing a procedure bilaterally typically involves more extensive time and resources, which justifies the additional reimbursement. In this context, receiving 150% of the single procedure payment rate ensures that ASCs are fairly compensated while still providing the necessary care to patients undergoing such procedures.

Other options do not align with the established reimbursement guidelines under the ASC PPS; therefore, they do not accurately reflect the compensation structure for bilateral procedures.