ASC or hospital. Who should decide site of service?

Physicians should decide whether procedures are performed in ASCs or hospital outpatient departments, Bill Prentice, CEO of the Ambulatory Surgery Center Association, said during the California Ambulatory Surgery Association's ASC Summit. 

Medicare's process for adding procedures to the ASC setting can be slow and erratic, Mr. Prentice said in the April meeting. CMS' removal of previously approved procedures, for example, has slowed the migration of cases to the ASC setting. 

Mr. Prentice added that instead of CMS having different procedure designations for hospital outpatient departments and ASCs, it should identify whether procedures are appropriate for inpatient or outpatient. The provider, Mr. Prentice said, should then decide the site of service. 

"The surgeon is the one who is best positioned to safely decide the setting that makes the most sense for that patient," he said in an email sent to Becker's.

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