TMPPM 2008 > Texas Medicaid Services > Ambulatory Surgical Center (ASC) > Reimbursement

9.2 Reimbursement

The Medicaid rates for ASCs are calculated in accordance with 1 TAC §355.8121. The current ASC/HASC fee schedule and ASC/HASC fee schedule insert are available on the TMHP website at www.tmhp.com/file library/file library/fee schedules. To request a hard copy of the fee schedule and insert, call the TMHP Contact Center at 1-800-925-9126.

When the procedure is not covered by a HCPCS code listed in the fee schedule, the provider should use revenue codes 960, 961, 962, 963, 964, and 969 or the appropriate HCPCS-defined unlisted procedure code from the fee schedule.

Physician and certified registered nurse anesthetist (CRNA) services performed in an ASC must be billed under the physician or CRNA provider identifier and are reimbursed separately.

Refer to: "Reimbursement" for more information about reimbursement.

"Hospital Ambulatory Surgical Center" for more information.