Medical necessity criteria of outpatient hospital services.
requires certain procedures and advanced imaging take place in a non-hospital affiliated outpatient facility.
Medicare
Procedure Price Lookup
Planning an outpatient procedure?
You may have options for where you have your outpatient procedure.
Compare national average prices for procedures done in both ambulatory surgical centers and hospital outpatient departments.
Aetna
Inpatient Admission Prior to Surgery
(Pre-op
Days)
-Aetna-
Anthem
Hospital-Based Ambulatory Surgical Procedures & Endoscopic Services
-Anthem-
Ambulatory or Outpatient Surgery Center Procedures
-Anthem-
Site of Care for Specialty Pharmaceuticals
-Anthem-
Outpatient Physical Therapy, Occupational Therapy, & Speech-Language Pathology Services
Site of Care
-Anthem-
Level of Care for Musculoskeletal Surgery & Procedures
-Anthem-
Site of Service - Advanced Radiologic Imaging
-Anthem-
Cigna
High-tech Radiology - Cigna
Medication Administration Site of Care
-Cigna-
Outpatient Hospital for Select Musculoskeletal Procedures
FloridaBlue
Site of Care Considerations for Select Specialty Medications
-FloridaBlue-
Humana
Site of Care and Specialty Medication Sourcing for Injectable Drugs
-Humana-
Site of Service - Advanced Radiologic Imaging
-Humana-
UHC
UHC Outpatient Surgical Procedures - Site of Service Criteria: Auditory System
UHC Outpatient Surgical Procedures - Site of Service Criteria: Cardiovascular System
UHC Site of Service Criteria: Computed Tomography (CT) Scan
UHC Outpatient Surgical Procedures - Site of Service Criteria: Digestive System
UHC Outpatient Surgical Procedures - Site of Service Criteria: Eye/Ocular Adnexa System
UHC Outpatient Surgical Procedures - Site of Service Criteria: Female Genital System
UHC Outpatient Surgical Procedures - Site of Service Criteria: Hemic & Lymphatic Systems
UHC Outpatient Surgical Procedures - Site of Service Criteria: Integumentary System
UHC Site of Service Criteria: Magnetic Resonance Imaging (MRI)
UHC Outpatient Surgical Procedures - Site of Service Criteria: Male Genital System
UHC Outpatient Surgical Procedures - Site of Service Criteria: Musculoskeletal System
UHC Outpatient Surgical Procedures - Site of Service Criteria: Nervous System
UHC Outpatient Surgical Procedures - Site of Service Criteria: Respiratory System
UHC Outpatient Surgical Procedures - Site of Service Criteria: Urinary System
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