Providers
Chapter 11
Section 6.2
Freestanding Ambulatory Surgery Center
(ASC)
Issue Date: June
20, 1988
Revision:
2.0 POLICY
2.1 Each contractor
is the certifying authority for applications for status as an authorized institutional
provider for freestanding ASCs located within their geographical
jurisdiction.
2.2 Freestanding ASCs are covered under
the following circumstances:
2.2.1 The treatment is prescribed and supervised
by a physician;
2.2.2 The type and level of care and services
rendered by the center are covered services;
2.2.3 The center meets
all licensing or other certification requirements of the jurisdiction
in which the facility is located; and
2.2.4 The center is accredited by the Joint Commission
or the Accreditation Association for Ambulatory Health Care, Inc.
(AAAHC), or other standards as authorized by the Director, Defense
Health Agency (DHA). Status as an accredited Medicare Freestanding
ASC is accepted in lieu of accreditation by the Joint Commission
or the AAAHC. The contractors may contact the Medical Benefits and Reimbursement
Section (MB&RS) Division to determine if other accreditation
organizations can be recognized by TRICARE.
2.2.5 A childbirth
procedure provided by an authorized freestanding ASC shall not be
covered unless the ASC is also an authorized birthing center institutional
provider as established by the birthing center provider certification
requirements.
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