---
kind: "section"
citation: "42 C.F.R. § 416.164"
title: "42"
number: "416.164"
heading: "Scope of ASC services."
url: "https://uscodex.org/cfr/42/416.164"
---

# §416.164. Scope of ASC services.

- (a) **Included facility services.** ASC services for which payment is packaged into the ASC payment for a covered surgical procedure under [§ 416.166](/cfr/42/416.166.md) include, but are not limited to—
  - (1) Nursing, technician, and related services;
  - (2) Use of the facility where the surgical procedures are performed;
  - (3) Any laboratory testing performed under a Clinical Laboratory Improvement Amendments of 1988 (CLIA) certificate of waiver;
  - (4) Drugs and biologicals for which separate payment is not allowed under the hospital outpatient prospective payment system (OPPS);
  - (5) Medical and surgical supplies not on pass-through status under [subpart G of part 419](/cfr/42/part419-subpartG.md) of this subchapter and not covered ancillary skin substitute supplies under [paragraph (b)](#b) of this section;
  - (6) Equipment;
  - (7) Surgical dressings;
  - (8) Implanted prosthetic devices, including intraocular lenses (IOLs), and related accessories and supplies not on pass-through status under [subpart G of part 419](/cfr/42/part419-subpartG.md) of this subchapter;
  - (9) Implanted DME and related accessories and supplies not on pass-through status under [subpart G of part 419](/cfr/42/part419-subpartG.md) of this subchapter;
  - (10) Splints and casts and related devices;
  - (11) Radiology services for which separate payment is not allowed under the OPPS and other diagnostic tests or interpretive services that are integral to a surgical procedure, except certain diagnostic tests for which separate payment is allowed under the OPPS;
  - (12) Administrative, recordkeeping and housekeeping items and services;
  - (13) Materials, including supplies and equipment for the administration and monitoring of anesthesia; and
  - (14) **Supervision of the services of an anesthetist by the operating surgeon.**
- (b) **Covered ancillary services.** Ancillary items and services that are integral to a covered surgical procedure, as defined in [§ 416.166](/cfr/42/416.166.md), and for which separate payment is allowed include:
  - (1) Brachytherapy sources;
  - (2) Certain implantable items that have pass-through status under the OPPS;
  - (3) Certain items and services that CMS designates as contractor-priced, including, but not limited to, the acquisition or procurement of corneal tissue for corneal transplant procedures;
  - (4) Certain drugs and biologicals for which separate payment is allowed under the OPPS;
  - (5) Certain radiology services and certain diagnostic tests for which separate payment is allowed under the OPPS;
  - (6) Non-opioid pain management drugs, biologicals, and medical devices as determined by CMS under [§ 416.174](/cfr/42/416.174.md); and
  - (7) **Groups of skin substitute supply products.**
- (c) **Excluded services.** ASC services do not include items and services outside the scope of ASC services for which payment may be made under [part 414](/cfr/42/part414.md) of this subchapter in accordance with [§ 410.152](/cfr/42/410.152.md), including, but not limited to—
  - (1) Physicians' services (including surgical procedures and all preoperative and postoperative services that are performed by a physician);
  - (2) Anesthetists' services;
  - (3) Radiology services (other than those integral to performance of a covered surgical procedure);
  - (4) Diagnostic procedures (other than those directly related to performance of a covered surgical procedure);
  - (5) Ambulance services;
  - (6) Leg, arm, back, and neck braces other than those that serve the function of a cast or splint;
  - (7) Artificial limbs;
  - (8) **Nonimplantable prosthetic devices and DME.**

## Notes

### Amendments

[72 FR 42545, Aug. 2, 2007, as amended at 79 FR 67030, Nov. 10, 2014; 80 FR 70604, Nov. 13, 2015; 83 FR 59178, Nov. 21, 2018; 86 FR 63992, Nov. 16, 2021; 89 FR 94588, Nov. 27, 2024; 90 FR 54084, Nov. 25, 2025]

### Source

Source: 72 FR 42545, Aug. 2, 2007, unless otherwise noted.

### Authority

Authority: 42 U.S.C. 273, 1302, 1320b-8, and 1395hh.

### Source

Source: 47 FR 34094, Aug. 5, 1982, unless otherwise noted.

### Amendments

[72 FR 42545, Aug. 2, 2007, as amended at 79 FR 67030, Nov. 10, 2014; 80 FR 70604, Nov. 13, 2015; 83 FR 59178, Nov. 21, 2018; 86 FR 63992, Nov. 16, 2021; 89 FR 94588, Nov. 27, 2024; 90 FR 54084, Nov. 25, 2025]