Certain Non-Surgical Services Procedure Codes No Longer Reimbursed Separately for HASC & ASC Provider

Date: December 30, 2024 

Attention: Hospital-based ambulatory surgery centers & ambulatory surgery centers

Effective for dates of service on or after December 1, 2024

Call to action: The purpose of this communication is to inform providers that effective for dates of service on or after December 1, 2024, certain non-surgical services procedure codes will no longer be reimbursed separately for hospital-based ambulatory surgery centers (HASC) and ambulatory surgery centers (ASC) because they are included in the Medicare ASC global payment. This change applies to Texas Medicaid and the Children with Special Health Care Needs (CSHCN) Services Program.

How this impacts providers: 

The following non-surgical services procedure codes will be affected under this change:

Resource: Draft of the updated ASC/HASC static fee schedule 

Next step for Providers: Providers are encouraged to share this communication with their staff.

If you have any questions, please email Provider Relations at: providerrelations@texaschildrens.org. 

For access to all provider alerts: https://www.texaschildrenshealthplan.org/providers/provider-news/provider-alerts.