Ambulatory Surgery Center Definition
"Ambulatory Surgical Treatment Centers" means any institution, building, or facility, or part thereof, devoted primarily to the provision of surgical treatment to patients not requiring hospitalization, as provided under provisions of O.C.G.A. § 31-7-1(4)(c). Such facilities do not admit patients for treatment which normally requires overnight stay, nor provide accommodations for treatment of patients for periods of twenty-four (24) hours or longer.
Excluded from the definition are:
- Currently licensed hospitals, or a hospital providing an ambulatory surgical treatment service
- A practitioner's private offices or treatment rooms in which a practitioner primarily sees, consults with and treats patients
- Facilities owned and operated by the Federal government
License Requirements
Any person or persons responsible for the operation of any institution, or who may hereafter propose to establish and operate an institution (defined by O.C.G.A. §31-7-1(4)(C) to include ambulatory surgical treatment centers) and to provide specified clinical services, shall submit an application to the department for a permit to operate the institution and provide such services, such application to be made on forms prescribed by the department. No institution shall be operated in this state without such a permit, which shall be displayed in a conspicuous place on the premises.
The licensing fee for ASCs is $750, due annually. ASCs are eligible for a 25% discount on their licensing fee if they are currently accredited by a nationally recognized accreditation organization approved by the department as having standards comparable to specific state licensure requirements and a complete copy of the current decision is submitted to the department at the time of annual license fee renewal. Currently the department will accept current accreditation at the level Medicare (CMS) accepts for deemed status from a CMS approved organization. An application processing fee of $300 is due on new applications, changes of ownership, changes in service level and name changes.
Any person violating the provisions of Title 31 (Health) of the Official Code of Georgia (which includes the licensing requirements for ASCs) shall be guilty of a misdemeanor.
Certificate of Need
Information about the CON program, applications and forms can be found here.
Length of Stay Restriction
ASCs do not admit patients for treatment which normally requires overnight stay, and may not provide accommodations for treatment of patients for periods of 24 hours or longer.
Medical History and Physical Examination
Georgia requires ASCs to maintain for each patient medical records containing sufficient information to validate the diagnosis and to establish the basis upon which treatment is given. Contents of individual medical records shall normally contain history and physical examination data containing personal medical history and a physical examination.
Transfer Agreement
Each ASC shall have a hospital affiliation agreement and/or the medical staff must have admitting privileges or other acceptable documented arrangements to insure the necessary backup for medical complications. The center must have the capability to transfer a patient immediately to a hospital with adequate emergency room services.
Price Transparency
Georgia does not impose state-level price transparency requirements on ASCs.
Workers' Compensation
Georgia's Workers' Compensation Medical Fee Schedule is only available by purchasing it through FAIR Health. In order to be reimbursed for workers’ compensation cases, ASCs must be Medicare-certified.
Patient Safety Reporting Requirements
While there are patient safety reporting requirements for Georgia hospitals, ASCs are not subject to these reporting requirements.
Charity Care
Georgia's CON laws and regulations impose charity care requirements on ASCs. An applicant for an ASC certificate of need shall foster an environment that assures access to services to individuals unable to pay and regardless of payment source or circumstances by providing a written commitment that unreimbursed services for indigent and charity care patients in the service will be offered at a standard which meets or exceeds 3% of annual gross revenues for the service after Medicare and Medicaid contractual adjustments and bad debt have been deducted. ASCs are additionally required to file an annual report detailing the amount of charity care provided.
Additionally, ASCs (single specialty and joint-venture) may secure exemption from CON requirements if they provide uncompensated indigent and charity care in the following amounts (and meet other state-specified requirements):
- Two percent of adjusted gross revenue if the ASC provides care to Medicaid beneficiaries and PeachCare for Kids beneficiaries (if applicable)
- Four percent of adjusted gross revenue if the ASC does not participate in Medicaid or PeachCare for Kids.
Single specialty ASCs operating pursuant to the CON exclusion adopted in 2008 must also provide indigent and charity care in the amounts shown above.
Changes to Georgia's CON laws in 2024 additionally provide that on and after January 1, 2026, a new minimum amount of charity care will be established by the Georgia Department of Community Health.
Surgical Smoke
Georgia requires ASCs to adopt policies for the reduction of human exposure to surgical smoke. Unlike other state requirements, Georgia does not mandate the use of a surgical smoke evacuation device.
Advance Directives
Advance Directives for Health Care: Duties and Responsibilities of Health Care Providers
Advance Directive Forms and Information
State Regulator
Georgia Department of Community Health
Healthcare Facility Regulation Division, Acute Care Section
2 Martin Luther King Jr. Drive SE, East Tower
Atlanta, Georgia 30334
Benjamin Arbise, Deputy Executive Director, Healthcare Facility Regulation Division
benjamin.arbise@dch.ga.gov
404.657.3990
Statutory & Regulatory References
Official Code of Georgia Annotated: §31-7
Georgia Rules and Regulations: Rules of Department of Community Health: Chapter 111-8-4, Healthcare Facility Regulation: Ambulatory Surgical Treatment Centers