Title 42, Part 416 — Ambulatory Surgical Services

Basis and scope.

Definitions.

Basic requirements.

Qualifying for an agreement.

Terms of agreement with CMS.

Termination of agreement.

Condition for coverage—Compliance with State licensure law.

Condition for coverage—Governing body and management.

Condition for coverage—Surgical services.

Conditions for coverage—Quality assessment and performance improvement.

Condition for coverage—Environment.

Condition for coverage—Medical staff.

Condition for coverage—Nursing services.

Condition for coverage—Medical records.

Condition for coverage—Pharmaceutical services.

Condition for coverage—Laboratory and radiologic services.

Condition for coverage—Patient rights.

Conditions for coverage—Infection control.

Conditions for coverage—Patient admission, assessment and discharge.

Condition for coverage—Emergency preparedness.

General rules.

Scope of facility services.

Covered surgical procedures.

Performance of listed surgical procedures on an inpatient hospital basis.

Applicability.

Basis for payment.

Applicability.

ASC facility services payment rate.

Publication of revised payment methodologies.

Surveys.

Basis and scope.

Applicability of this subpart.

General rules.

Scope of ASC services.

Covered surgical procedures.

Basis of payment.

Determination of payment rates for ASC services.

Adjustments to national payment rates.

Publication of revised payment methodologies and payment rates.

Payment for non-opioid pain management drugs, biologicals, and medical devices.

Limitations on administrative and judicial review.

Payment and coinsurance reduction for devices replaced without cost or when full or partial credit is received.

Basis and scope.

Process for establishing a new class of new technology IOLs.

Request for review of payment amount.

Determination of membership in new classes of new technology IOLs.

Payment adjustment.

Basis and scope of subpart.

Participation and withdrawal requirements under the ASCQR Program.

Data collection and submission requirements under the ASCQR Program.

Public reporting of data under the ASCQR Program.

Retention and removal of quality measures under the ASCQR Program.

Measure maintenance under the ASCQR Program.

Reconsiderations under the ASCQR Program.