Clarification of Ambulatory Surgery Center (ASC) Grouper Reimbursement

Ambulatory surgery facility charges fall into one of 11 TRICARE grouper rates. The rates established under this system apply only to the facility charges for ambulatory surgery. While it may not always be clear what is included in ambulatory surgery center (ASC) rates, the following tables illustrate what services are included in the ASC grouper reimbursement and for which services providers can expect additional payment above the ASC grouper allowable amount. The revenue code and service description is listed in the tables.

Services Included in ASC Grouper Reimbursement

Revenue Code

Service Description

25X

Pharmacy

26X

Intravenous (IV) Therapy

270-272

Supplies

274-276

Supplies; excluding implants

278-279

Supplies; excluding implants

28X

Oncology

29X

Durable Medical Equipment (DME)

36X

Operating room

37X

Anesthesia

390, 399

Blood Storage and Processing

560,569

Medical Social Services

62X

Medical Surgical Supplies

630-633, 637

Drugs

70X

Cast Room

71X

Recovery Room

720-721

Labor Room

762

Observation Bed

810,819

Organ Acquisition except corneal tissue transplant

942

Education/Training

Services Paid in Addition to ASC Grouper Reimbursement

Revenue Code

Service Description

274

Prosthetic

275

Pacemaker

276

Intraocular lenses (IOL)

278

Other Implants

279

Other Devices

30X

Lab

31X

Lab

32X

Diagnostic Radiology

33X

Therapeutic Radiology

34X

Nuclear Medicine

35X

CT Scan

38X

Blood

39X

Blood

40X

Other Imaging

41X

Respiratory Services

42X

Outpatient rehabilitation

43X

Outpatient rehabilitation

44X

Outpatient rehabilitation

45X

Emergency Room (ER)

46X

Pulmonary Function

47X

Audiology

48X

Cardiology

51X

Clinic

54X

Ambulance

623

Surgical Dressings

636

Detailed Drugs

73X

EKG/EEG

74X

EEG

75X

Gastrointestinal services (IF billed with a surgical code, it is included in the Grouper.)

92X

Other Diagnostic tests

For additional information, ambulatory surgery providers can refer to www.tricare.mil/ambulatory, the TRICARE Reimbursement Manual at http://manuals.tricare.osd.mil/, the TriWest website at www.triwest.com or call 1-888-TRIWEST (1-888-874-9378).

Please note: OPPS will override this matrix upon OPPS implementation June 1, 2007.