Medicare program; ambulatory surgical services--Health Care Financing Administration. Final rule

These regulations implement in part, section 934 of Pub. L. 96-499, the Omnibus Reconciliation Act of 1980, which adds to the benefits available under Part B of Medicare, facility services associated with certain surgical procedures provided in an ambulatory surgical center. That section also provides, under certain conditions, for 100 percent Medicare reimbursement to physicians (rather than the usual 80 percent) for services provided in connection with certain surgical procedures performed on an ambulatory basis. These regulations establish: (1) The standards an ambulatory surgical center must meet to be approved for participation in the Medicare program; (2) criteria for determining which surgical procedures will be included for purposes of reimbursing facilities and physicians under this provision; (3) the payment methodology and reimbursement procedures with respect to facility services; and (4) the requirements relating to agreements by the facility to furnish services under the program and by physicians with respect to accepting payments for procedures (agreements to accept "assignments"). The purpose of the legislation and these regulations is to encourage the performance in an ambulatory setting of certain surgical procedures that are now frequently furnished on an inpatient hospital basis.