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Common Outpatient Workers' Compensation Procedures Should Be Done in Hospitals

• Most ambulatory surgical centers eligible for a California Official Medical Fee Schedule facility fee, or alternatively, a particular class of ASCs, are generally equipped to provide services to the workers' compensation population that do not require a one-night stay.
• Some such procedures may be more appropriately performed as a hospital outpatient procedure than as an ASC procedure because hospitals have the ready availability of emergency and observation services for overnight stays that go beyond ASC services.

Cervical Spinal Fusions Might Be Added to ASC Fee Schedule, with Candidate Criteria

• Data analyses and literature review did not provide strong support for adding any procedures to the ASC fee schedule with the possible exception of procedures related to cervical spinal fusions.
• While the literature suggests that two-level anterior cervical fusions and the use of instrumentation for one- or two-level fusions can be performed safely on an outpatient basis, it lacks evidence-based selection criteria to suggest which patients are candidates for the procedures in an outpatient setting.

A Fee Schedule Allowance for Inpatient ASC Procedures Cannot Now Be Set

• Data are not readily available to establish an appropriate fee schedule allowance for "inpatient only" procedures in an ASC setting.
• A single multiplier applied to the inpatient rate is not suitable for the full range of common inpatient procedures because of differences in the average costs for the average inpatient relative to the average cost for patients most likely to be candidates for ambulatory surgery.