Packaged facility services
Nursing, supplies, equipment, dressings, and most implants are packaged into the procedure payment. CMS notes that reporting packaged charges as separate line items can lead to incorrect payment.
Your facility claim is not the surgeon's claim
An ambulatory surgery center is paid for the room, staff, supplies, and most implants, while surgeons and anesthesia bill their own professional claims. Keeping those lanes clean is most of the work.
Book a demoHow ASC payment works
Medicare pays ASCs a facility rate tied to each covered surgical procedure. Most of the cost of a case is bundled into that rate.
Covered procedures and ancillaries
CMS publishes the procedures it pays in ASCs and assigns each a payment indicator, with quarterly updates. Some ancillary items, such as certain drugs, pass-through devices, and radiology, are paid separately when integral to a covered procedure.
Professional claims stay separate
Surgeons and anesthesia practitioners bill their own professional services on their own claims. The facility payment never includes physician services.
Drawing the line between facility and physicians
Many centers share ownership with the surgeons who operate there, but the billing still splits in two.
What the center keeps
Scheduling, case records, implant logs, and supply tracking stay with your staff. Your clinicians approve codes before submission.
What Taiga takes on
For claims in scope, Taiga drafts codes from operative notes, verifies eligibility, scrubs against payer rules, submits, and works every denial and appeal. Patient statements follow the same process.
What needs a decision
Decide whether the surgeons' professional billing moves with the facility work or stays where it is. Implant invoices and commercial contract carve-outs also need an owner.
Questions for an ASC fit call
Bring a de-identified sample of recent cases, including one with an implant and one with multiple procedures.
What does your case mix look like?
List your top specialties and procedures, and which ones carry device or implant costs.
How are charges built?
Explain who builds the charge from the operative note and how packaged supplies are recorded.
Which contracts matter most?
Name your main payers and any contracts that pay implants or multiple procedures differently.
For physician-owned surgery centers
Useful for an independent or physician-owned surgery center that wants facility claims, denials, and patient balances handled by one accountable team.
Where this page stops
Surgery centers are not on Taiga's published specialty list, so bring your service mix and Taiga will tell you straight whether it fits. Covered procedure lists and payment indicators change every year, and nothing here is a coverage determination.
Questions about surgery centers billing
Does the surgeon bill on the same claim as the center?
No. The center bills its facility services, and the surgeon and anesthesia practitioner bill their professional services separately. For Medicare, ASC facility claims still go out in the professional format (837P or CMS-1500), which surprises many new billers.
Can we bill supplies and implants as separate lines?
Usually not for Medicare. Most supplies and implants are packaged into the procedure rate, and only certain items, such as pass-through devices, are paid separately. Commercial contracts may carve out implants, so read each one.
What happens if a procedure is not on the ASC covered list?
Medicare does not pay the center a facility fee for it. The physician can still bill the professional service, and the patient may be liable for the facility charge.
Can Taiga take over our open A/R?
Once fit is confirmed, Taiga can take over open A/R or run in parallel with your current process. Onboarding takes about two weeks to first claim.
Bring your facility and physician claim map
Show Taiga which claims the center sends and which the surgeons send. You will learn quickly what fits and how onboarding would run.
System guides show possible billing handoffs, not proven specialty compatibility.