PHIC PHILHEALTH CIRCULAR NO. 39, S. 2002

: Only ambulatory surgical services with a Relative Value Unit (RVU) of 200 and below in the Relative Value Scale 2001 shall be compensated.
: No, these procedures with RVU of 200 and below that require more than 24 hours confinement shall not be compensated if performed as outpatient services for patient safety reasons.
: Claims with total RVU of 201 and above will be disallowed to ensure patient safety.
: Ambulatory surgical clinics are deemed analogous to secondary hospitals and are given the same benefit limits as these hospitals.
: Each use of the ambulatory surgical facility is considered as one day charged to the 45-day annual benefit limit.
: Only those used on the day of the surgery shall be reimbursed.
: Yes, only those considered necessary such as intraoperative biopsies are covered.
: Payment for the operating room is based on the RVU of the procedure; professional fees of the surgeon are based on the RVU and the existing Peso Conversion Factor (PCF).
: No, anesthesiologist care for local anesthesia is not covered except for regional nerve block.
: Surgical procedures performed in accredited ASCs with extended stay beyond 24 hours shall be denied compensation.