US · guidance
CMS Pub. 100-04, ch. 14, § 20.1
Nature and Applicability of ASC Covered Procedures List
The ASC list of covered procedures merely indicates procedures which are covered and
paid for if performed in the ASC setting. It does not require the covered surgical
procedures to be performed only in ASCs. The decision regarding the most appropriate
care setting for a given surgical procedure is made by the physician based on the
beneficiary’s individual clinical needs and preferences. Also, all the general coverage
rules requiring that any procedure be reasonable and necessary for the beneficiary are
applicable to ASC services in the same manner as all other covered services.
History
(Rev. 11793; Issued:01-19-23; Effective: 02-21-23; Implementation: 02-21-23)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
459bf61d39063bbff8f048ad39ac5f57e8aec9723a4ebdfd14e14cede0867e30
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