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TRICARE Policy Manual 6010.60-M, April 1, 2015
Chapter 11
Section 6.1
Ambulatory Surgery
Issue Date:  August 31, 1987
Authority:  Public Law 95-552 and 32 CFR 199.14
Surgery provided to the patient on an outpatient, walk-in, same day basis in an appropriately equipped and staffed health facility with surgery usually conducted under general anesthesia with no overnight stay in the hospital required. Also called same day surgery.
2.1  Benefits are payable for medically necessary surgical procedures when ordered and provided or supervised by a physician, and performed in authorized freestanding ambulatory surgical facilities or hospital outpatient setting (e.g., a clinic, Ambulatory Surgery Center (ASC), or Emergency Room (ER)).
2.2  Institutional charges submitted by unauthorized ambulatory surgery centers cannot be covered.
2.3  Professional services provided by authorized individual professional providers in an unauthorized ambulatory surgical center will be covered on an outpatient basis if the surgical procedure is a covered benefit.
2.4  Professional services provided by employees of unauthorized centers cannot be covered.
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