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Surgical Procedures Performed in the Physician's and Other Professional Provider's Office

When performing surgical procedures in a non-facility setting, the physician's and other professional provider's reimbursement is all-inclusive. Our payment covers all of the services, supplies, and equipment needed to perform the surgical procedure when a member receives these services in the physician's and other professional provider's office. Please note the physician and other professional provider reimbursement includes surgical equipment which may be owned or supplied by an outside surgical equipment or Durable Medical Equipment (DME) vendor. Claims from the surgical equipment or Durable Medical Equipment (DME) vendor will be denied based on the fact that the global physician and other professional provider reimbursement includes staff, supplies and equipment.