Nature and Applicability of ASC Covered Procedures List

20.1 - Nature and Applicability of ASC Covered Procedures List (Rev. 11793; Issued:01-19-23; Effective: 02-21-23; Implementation: 02-21-23) The ASC list of covered procedures merely indicates procedures which are covered and paid for if performed in the ASC setting. It does not require the covered surgical procedures to be performed only in ASCs. The decision regarding the most appropriate care setting for a given surgical procedure is made by the physician based on the beneficiary’s individual clinical needs and preferences. Also, all the general coverage rules requiring that any procedure be reasonable and necessary for the beneficiary are applicable to ASC services in the same manner as all other covered services.