Ambulatory Surgical Center
This page is a central location for ambulatory surgical center (ASC) information, including CMS resources.
Spotlight
- MLN Connects Newsletter for August 20, 2026: Claims, Pricers & Codes - Encelto™ Cell Gene Therapy Drug: Get Billing Guidance
- MLN Matters Article MM14634, Ambulatory Surgical Center Payment System – October 2026 Update
Enrolling
The following resources support enrollment activities for ASCs:
- Conditions for Coverage (CfC) & Conditions of Participation (CoPs)
- State Operational Manual, Appendix L - Guidance for Surveyors: Ambulatory Surgical Centers
Policy Information
Not all services have a policy associated with them. We will consider Reasonable and Necessary Guidelines in the absence of an LCD, billing and coding article, NCD, or CMS manual instruction that limits coverage.
LCDs
Learn more about the LCD development process through the following:
Search for ASC-related NCDs using these available tools:
- LCD Interactive Index Tool
- View active / proposed LCDs on CMS Medicare Coverage Database (MCD)
NCDs
Search for ASC-related NCDs using these available tools:
Medical Documentation
For a claim to be valid, documentation must demonstrate compliance with all applicable coverage, coding and billing requirements and substantiate the level of care billed. The following resources are specific to ASC, but may not address all required medical documentation requirements:
- CMS IOM Pub.100-02 Medicare Benefit Policy Manual, Chapter 15, Section 260
- CMS IOM Pub.100-04 Medicare Claims Processing Manual, Chapter 14
Claim Submission and Reimbursement
- Prior Authorization Demonstration for Certain ASC Services
- Fee Schedules - ASCs
- Core-Based Statistical Areas for ASCs - Florida
- Core-Based Statistical Areas for ASCs - Puerto Rico
- ASC Payment Indicators
- ASC Payment Rates - Addenda
- Modifiers Applicable to ASCs
Additional Information
- Encelto Cell Gene Therapy Drug
- ASC Billing Tips
- Drugs and Biologicals Part B: Using the JW and JZ Modifiers
- Process for Supplying Invoice Amount on Certain HCPCS Codes - Avoid Rejected Claims
- Physician Billing for Procedures Performed in an ASC
- ASC Terminated Procedures
- ASC Pass-Through Devices
- View our FastTrack to Medicare Coverage Policies Tool to locate guidelines
CMS
- Ambulatory Surgical Center (ASC) Payment
- Ambulatory Surgical Centers Information Center
- MLN Compliance, Medicare Provider Compliance Tips, Ambulatory Surgical Centers
- MLN Education Tool MLN6922507, Medicare Payment Systems - Ambulatory Surgical Center Payment System & Coverage
- Prior Authorization Demonstration for Certain Ambulatory Surgical Center (ASC) Services
- MLN Matters Article MM14359, Ambulatory Surgical Center Payment System: January 2026 Update
- MLN Matters Article MM14359, Ambulatory Surgical Center Payment System: April 2026 Update
- MLN Matters Article MM14522, Ambulatory Surgical Center Payment System – July 2026 Update
Education
View our wide selection of free, live and on-demand training options:
- View our upcoming Educational Events Calendar
- View On-Demand Learning
Stay Informed
Stay updated on the latest Medicare information with free email subscriptions: