Do you need a CON?
Twenty-seven states have blanket certificate of need (CON) laws and 10 states have CON laws that do not include ASCs, according to The Federated Ambulatory Surgery Association. Many of these same states will let physicians develop a practice office-based facility without facing the barrier or the high costs (typically ranging from $50,000 to $100,000) of obtaining a CON. In the 14 states without a CON requirement, you can develop either a surgical hospital or an ASC. Different reimbursements for different settings. In an office-based facility that is not certified as an ASC, a physician may receive a higher fee for his professional services (a site-of-service differential). This is intended to reflect the increased overhead costs of performing surgical procedures in the office setting. This enhancement is usually far less than the facility fee received by an ASC, which is usually based on either one of eight specified reimbursement levels (known as groupings) for ambulatory surgical procedures, or a discount from the ASC's charge schedule.