Customized Medical Billing Services for Ambulatory Surgery Centers

Did you know that for Medicare patients, ASCs should report bilateral procedures as a single unit on two separate lines or with “2” in the units field on one line in order for both procedures to be paid? CMS will not recognize the use of the -50 modifier for payment purposes and may result in incorrect payment to ASCs. The multiple procedure reduction of 50 percent will apply to all bilateral procedures subject to multiple procedure discounting.

ASC billing is highly complex, ever-changing and requires a high level of knowledge to ensure proper reimbursement. With surgery centers facing increasing operational costs, continuing downward pressure on revenues and increasing patient responsibility, ASCs cannot afford to leave any money on the table, which is why they require efficient and accurate billing procedures. 

PGM is well versed in billing for ASCs of all sizes for all of their specialties. We will work in conjunction with your ASC to ensure you receive the appropriate reimbursement for the surgeries and procedures your physicians perform. PGM will identify problem areas such as the correct use of modifiers, evaluate underpayments and manage all aspects of your ASC’s billing. Our core team of medical billing specialists have many years of experience with ICD-9, CPT and HCPCS coding systems and our medical coders are certified by the American Association of Professional Coders. They will work hand in hand with your ASC to provide education on best-in-class billing practices and procedures.

To learn more about why PGM’s billing services are what your ASC needs, contact us for more information.