ASC SPECIALTY HUB — PAGE 13 OF 13
Developed by GoHealthcare Practice Solutions
ASC State Regulatory Profiles — Volume Two
South and Southeast — Licensure, Facility Categories, Need Review, and Utilization Review Law in Twelve States
The second volume of the GoHealthcare ASC State Regulatory Profiles series. It provides a verified, citation-level profile of ambulatory surgical facility regulation in Alabama, Arkansas, Florida, Georgia, Kentucky, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee, Virginia, and West Virginia — the region carrying the heaviest concentration of certificate of need reform activity in the country.
Publication Information
Document Control
| Document Title | ASC State Regulatory Profiles — Volume Two — South and Southeast — Licensure, Facility Categories, Need Review, and Utilization Review Law in Twelve States |
|---|---|
| Series | GoHealthcare MSK Specialty Procedure Library™ — ASC Specialty Hub |
| Document Identifier | GH-MSK-HUB-ASC-P13 |
| Standard Applied | GoHealthcare Clinical Procedure Guide Standard v1.0 |
| Publication Date | August 3, 2026 |
| Document Version | Version 1.0 |
| Developed By | GoHealthcare Practice Solutions, under the leadership of Pinky Maniri, Founder and Chief Executive Officer |
ASC Specialty Hub
Purpose, Audience, and Sources
| Purpose | Provide ASC leaders, developers, counsel, and multi-state operators with a verified starting point for state regulatory research in the South and Southeast, using a consistent profile structure across the series. |
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| Primary Audience | Physicians; ASC administrators, developers, and executives; healthcare counsel; prior authorization and utilization management teams; revenue cycle leaders; multi-state operators; compliance officers |
| Credentials | MSc, CRCR, CSAPM, CSPPM, CSBI, CSPR, CSAF, Certified in Healthcare A.I. Governance |
| Primary Sources | State statutes and administrative codes as cited per jurisdiction; state licensing agency published materials; National Academy for State Health Policy 50-state certificate-of-need database updated December 12, 2025; CMS ASC Prior Authorization Demonstration and WISeR Model materials; 42 CFR Part 416, Subpart C; state enactments through mid-2026 |
| Scope Exclusions | This volume does not state legal conclusions, does not opine on the lawfulness of any structure or arrangement, and does not substitute for primary state legal research or advice from counsel licensed in the relevant jurisdiction. Statutory and regulatory citations are provided as verified research starting points and are subject to amendment, renumbering, and readoption. Where a profile states that a requirement was not located in the sources consulted, that means exactly that — not that no such requirement exists. |
| Website | https://www.gohealthcarellc.com |
ASC Specialty Hub
ASC Specialty Hub — Page Index
This page is one of thirteen in the GoHealthcare Ambulatory Surgery Center Specialty Hub. Each page is written to stand alone for the team that owns that domain, and to connect to the domains upstream and downstream of it.
| # | Knowledge Center page | # | Knowledge Center page |
|---|---|---|---|
| 01 | Specialty Overview | 08 | KPIs and Metrics |
| 02 | Practice Operations | 09 | AI Applications |
| 03 | Prior Authorization | 10 | Best Practices |
| 04 | Revenue Cycle | 11 | Procedure Links |
| 05 | Documentation | 12 | Frequently Asked Questions |
| 06 | Coding | 13 | State Regulatory Reference ◀ you are here |
| 07 | Compliance |
01
ASC Specialty Hub
Scope and Method of This Volume
This volume is the second of four in the GoHealthcare ASC State Regulatory Profiles series. It covers twelve South and Southeast states: Alabama, Arkansas, Florida, Georgia, Kentucky, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee, Virginia, and West Virginia.
The profile structure is identical to Volume 1: licensing authority and statutory grant, licensure regulation, facility categories and definitional thresholds, need review regime and its applicability to ambulatory surgery, accreditation interaction, notable operational requirements that differ from the federal Conditions for Coverage, Medicare prior authorization program participation, and identified state utilization review law.
Verification Standard for This Volume
Each citation in this volume was located in a primary or official state source during preparation. State statutes and administrative rules are amended continuously and are frequently renumbered or readopted, and several states in this region have reorganized their health agencies recently.
This volume is a research starting point and an orientation, not legal advice and not a substitute for primary state legal research. Confirm the current text of any cited provision with the state agency and obtain review by qualified healthcare counsel licensed in that jurisdiction before relying on any threshold or exemption stated here.
Where a profile states that a requirement was not identified, that means it was not located in the sources consulted — not that it does not exist.
Why This Region Is Different
This region carries the heaviest concentration of certificate of need reform activity in the country. South Carolina removed ambulatory surgery from CON entirely in 2023; Tennessee repealed the ASC CON requirement subject to TennCare participation conditions; Georgia created single-specialty exemptions; North Carolina has been progressively narrowing its program. A development analysis based on a pre-2023 understanding of Southeastern CON will be wrong in several states at once.
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ASC Specialty Hub
Alabama
| Licensing authority | Alabama Department of Public Health, Division of Licensure and Certification, under the Alabama State Board of Health. Statutory authority in Code of Ala. 1975, § 22-21-20 et seq. and § 22-2-2(6) et seq. |
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| Licensure regulation | Alabama Administrative Code Chapter 420-5-2, Ambulatory Surgical Treatment Facilities — covering administration (420-5-2-.02), patient care (420-5-2-.03), and physical environment. The chapter was originally filed September 1, 1982 and has been amended repeatedly, including amendments published January 31, 2025 effective March 17, 2025, and published September 30, 2025. Confirm the currently effective text. |
| Facility category | "Ambulatory surgical treatment facility" — a health care institution serving patients not requiring hospitalization, within the broader statutory definition of hospitals and related health care institutions. |
| Anesthesia personnel | General, regional, or local anesthesia may be administered only by an anesthesiologist, a Certified Registered Nurse Anesthetist, an Anesthesiologist Assistant licensed by the Alabama Board of Medical Examiners, or another qualified individual as specified in the rule. |
| Physical plant | Chapter 420-5-2 prescribes minimum room dimensions and finishes, including a minimum room size specification and requirements for scrub areas convenient to operating rooms, and references life safety standards for ambulatory health care centers. Plan submission requirements appear at Chapter 420-5-22. |
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| Ancillary service cross-references | Radiological services must comply with the requirements in Chapter 420-5-7 (Hospitals) governing radiological equipment, radiation protection, and calibration. Dietary services cross-reference Chapter 420-3-14 (Food Service Sanitation). |
| Need review | Alabama maintains a certificate of need program. Confirm current administering body, thresholds, and ambulatory surgery applicability directly with the State; CON reform legislation has been announced in recent sessions. |
| Medicare prior authorization | Not a WISeR state. Not an ASC Prior Authorization Demonstration state. |
| State utilization review law | SB 63, signed April 2026, effective October 1, 2026 — a decision to deny, delay, or modify a prior authorization request based on medical necessity must always be made by a licensed physician or other health care professional competent to evaluate any recommendation or conclusion of artificial intelligence. Plans must certify annually to the department that their AI does not rely on a group dataset, is applied fairly and equitably, and does not discriminate, and must make prominent written disclosure of AI use in utilization review policies and procedures. |
Operational Note
Alabama amended Chapter 420-5-2 twice during 2025. Any Alabama compliance manual or physical plant assumption carried forward from an earlier build should be re-verified against the current chapter text rather than a prior copy.
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ASC Specialty Hub
Arkansas
| Licensing authority | Arkansas Department of Health, under rules promulgated by the Arkansas State Board of Health. Outpatient surgery centers are licensed within the Rules for Hospitals and Related Institutions framework; no such facility may be established, conducted, or maintained without first obtaining a license. |
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| Licensure regulation | Rules for Hospitals and Related Institutions in Arkansas, with ambulatory surgery centers addressed at 20 CAR § 41-138 and ambulatory surgery services addressed within the specialized services sections. Licensure and application provisions reference Ark. Code Ann. § 20-9-214. |
| Facility definition | A facility in which surgical services are offered that require the use of general or intravenous anesthetics, and where in the opinion of the attending physician hospitalization is unnecessary, is an ambulatory/outpatient surgery center. |
| Exclusions | The definition does not include (a) a medical office owned and operated by one or more physicians licensed by the Arkansas State Medical Board if the office does not bill facility fees to a third-party payor; or (b) a dental office holding a Facility Permit for Moderate Sedation or for General/Deep Sedation from the Arkansas State Board of Dental Examiners. |
| Procedure scope limits | Procedures performed in an ASC must be those commonly performed on an inpatient basis in hospitals but safely performable in an ASC; not of a type commonly or safely performed in physician offices; and limited to those requiring a dedicated operating room or suite and generally requiring a postoperative recovery room or short-term, not overnight, rooms. |
| Emergency transfer | The ASC must either have a written agreement with a local hospital for transfer of a patient in a medical emergency that cannot be handled in the center, or ensure that every physician performing surgery at the ASC has admitting privileges. |
| License term and transferability | Licenses are issued only for the premises and persons named in the application and are not transferable; the license expires on a change of ownership and must be posted conspicuously. |
| Need review | Arkansas is a non-CON jurisdiction for ambulatory surgery under the certificate of need scan consulted. Confirm no successor review requirement applies to the specific project. |
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| Medicare prior authorization | Not a WISeR state. Not an ASC Prior Authorization Demonstration state. |
| State utilization review law | Gold carding program amended in 2025 to refine evaluation periods and eligibility criteria. Confirm the current threshold and look-back. |
Operational Note
Arkansas is one of the few states that expressly limits ASC scope by reference to what is not appropriate for a physician office. A center adding low-acuity office-appropriate procedures to fill schedule gaps should confirm that the additions remain within the state's definition of ambulatory surgery, independent of what the payer's covered procedures list allows.
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ASC Specialty Hub
Florida
| Licensing authority | Agency for Health Care Administration (AHCA), Division of Health Quality Assurance, Bureau of Health Facility Regulation — Hospital and Outpatient Services Unit. A license is required to operate an ambulatory surgical facility, and it is unlawful to advertise a facility as an ambulatory surgical facility without one. |
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| Statutory basis | Chapter 395, Part I and Chapter 408, Part II, Florida Statutes. Rulemaking authority at § 395.1055; patient rights implemented through §§ 381.026, 395.301 and 395.3025; accreditation report public record provision at § 395.0162; construction exemption reference at § 395.0163. |
| Licensure regulation | Florida Administrative Code Chapter 59A-5, Ambulatory Surgical Center Licensure — definitions (59A-5.002), licensure procedure (59A-5.003), validation, licensure and life safety inspections and complaint investigations (59A-5.004), governing board (59A-5.005), patient rights (59A-5.0065), organized medical staff (59A-5.007), departments and services (59A-5.0085), surveillance, prevention and control of infection (59A-5.011), medical records (59A-5.012), physical plant maintenance (59A-5.016), fire control (59A-5.017), and comprehensive emergency management plan (59A-5.018). |
| Accreditation deeming | Accreditation is voluntary. Accredited ASCs meeting Rule 59A-5.004(3) may be deemed in compliance with licensure and certification requirements and are not scheduled for routine on-site licensure or recertification surveys, although periodic Life Safety Code inspections are still required. The facility must provide a complete copy of the most recent survey report evidencing continued accreditation; that report becomes part of the public facility file under § 395.0162. Loss of accreditation, a status other than accredited, or failure to submit documentation returns the facility to annual survey. |
| Construction review | Plan review proceeds in staged reviews through AHCA's Office of Plans and Construction, with Stage II preliminary plan approval and Stage III construction document review; the Florida Building Code Section 451 addresses ambulatory surgical center design and construction standards. Initial applicants must have a current project under review with the Office of Plans and Construction. |
| Change reporting | Changes to name, address, number of operating rooms, procedure rooms, or recovery beds require a change application submitted 60 days prior to the change; late submission is subject to a $500 fine under Rule 59A-35.040(3). Changes to personnel or controlling interest that do not constitute a change of ownership must be reported within 21 calendar days under § 408.810(3). |
| Emergency management | Each ASC must develop, adopt, and annually review a written comprehensive emergency management plan developed in conjunction with other local agencies and providers. |
| Need review | Florida substantially rolled back its certificate of need program; ambulatory surgery is not subject to CON. Confirm current status for the specific project type. |
| Medicare prior authorization | ASC Prior Authorization Demonstration Phase 1 state. Requests accepted from January 5, 2026 for dates of service on or after January 19, 2026. Not a WISeR state. |
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| State utilization review law | No AI-in-utilization-review enactment identified in the sources consulted. |
Operational Note
The 60-day advance change application for operating room, procedure room, or recovery bed count is a real operational constraint in Florida. A center that converts a procedure room to an operating room to absorb higher-acuity musculoskeletal volume has made a licensure change, not just a scheduling change, and the timeline should be built into the conversion plan.
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ASC Specialty Hub
Georgia
| Licensing authority | Department of Community Health, Healthcare Facility Regulation. Georgia issues a permit rather than a license; no ambulatory surgical treatment center may operate in Georgia without a valid permit, which must be displayed conspicuously within the center. |
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| Licensure regulation | Ga. Comp. R. & Regs. Chapter 111-8-4 (also cited as 111-8-04), Ambulatory Surgical Treatment Centers — including definitions, exemptions, organization and administration, classification of services, application for permits (111-8-4-.05), permits (111-8-4-.06), provisional permits, inspections, professional services, physical plant and operational standards (111-8-4-.10), personnel, clinical laboratory services, sterile supplies, drug storage and dispensing, blood supply and storage, x-ray, electrical power, advertising (111-8-4-.21), and waiver of rule. Enforcement reference at O.C.G.A. § 31-2-8. |
| Classification of services | Each center must designate on application the type or classification of services to be provided — examples include general surgery; eye, ear, nose and throat; plastic surgery; oral and maxillofacial; obstetrical-gynecological; oncological; ophthalmological; and urological. The permit may cover one or more service types, and the center may provide only those services listed on the face of its permit. The permit also states patient capacity. |
| Advertising | Any advertising of services provided in or by an ambulatory surgical treatment center must include the full name of the center and its Georgia license number as shown on the face of the permit. |
| Plan review | Plans must be submitted to the Department and approved in three stages of development. |
| Separate premises | Separate applications and permits are required for centers maintained on separate premises even under common ownership. |
| Change of ownership | Subject to the notice requirements of O.C.G.A. § 31-6-40.1. Each planned change of ownership or lease must be reported to the Department thirty days prior, with an application from the proposed new owners for a new permit. |
| Need review | Georgia Certificate of Need Law, O.C.G.A. § 31-6 et seq., with rules at Ga. Comp. R. & Regs. Chapter 111-2-2. Ambulatory surgical treatment centers are subject to Department review under the CON law, and evidence of completed review must accompany the permit application. Under O.C.G.A. § 31-6-70(a), data reporting requirements apply to all ambulatory surgical centers and imaging centers beginning July 1, 2008, whether or not exempt from obtaining a CON. 2024 reforms exempt certain single-specialty ASCs from review where owned by a single physician or practice and below specified capital expenditure and operating room thresholds, and permit non-owner physicians in the same specialty to practice in those centers and joint ventures with hospitals. |
| Medicare prior authorization | ASC Prior Authorization Demonstration Phase 1 state. Requests accepted from January 5, 2026 for dates of service on or after January 19, 2026. Not a WISeR state. |
| State utilization review law | SB 444, effective January 1, 2027 — AI systems may automate tasks and participate in decision-making but may not issue an adverse determination to a patient until a natural person qualifying as a private review agent or a utilization review entity conducts a utilization review in which a clinical peer participates. |
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Operational Note
Georgia's permit is service-specific. A center permitted for one classification cannot simply begin providing another — adding a service line is a permit amendment. For MSK centers expanding from pain management into orthopedic surgery, or from general orthopedics into spine, confirm the permit classification before the first case is scheduled. Note also that CON exemption does not exempt a center from CON data reporting.
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ASC Specialty Hub
Kentucky
| Licensing authority | Cabinet for Health and Family Services. Under KRS 216B.105, no person may operate a health facility in the Commonwealth without first obtaining a license issued by the cabinet. Licensure standards authority at KRS 216B.042(1)(a) and (c). |
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| Licensure regulation | 902 KAR 20:106, Operation and services; ambulatory surgical center — establishing minimum licensure requirements for the operation of and services provided by ambulatory surgical centers. Related provisions at 902 KAR 20:101 (license definition) and 902 KAR 20:074 (outpatient health care centers, which may include an ambulatory surgery component in qualifying counties). |
| Facility definition | A public or private institution established, equipped, and operated primarily for the purpose of providing surgical services to patients not requiring hospitalization and whose recovery under normal circumstances is not expected to require inpatient care. |
| Statutory cross-references | 902 KAR 20:106 relates to KRS 211.842–211.852, 216B.015, 216B.042, 216B.153, 216B.165, 216B.990, 311.400, 311.571, 311.710–311.810, 313.010(9), 313.030, 314.041, 314.042, 314.051, 333.030, and to the HIPAA privacy and security rules at 45 C.F.R. Parts 160 and 164. |
| Postanesthesia recovery | Section 5 of 902 KAR 20:106 addresses postanesthesia recovery services and staffing. |
| Need review | Kentucky maintains a certificate of need program administered through the Cabinet for Health and Family Services under KRS Chapter 216B. Confirm current thresholds and ambulatory surgery applicability with the Cabinet. |
| Medicare prior authorization | Not a WISeR state. Not an ASC Prior Authorization Demonstration state. |
| State utilization review law | Prior authorization exemption legislation under consideration. Confirm current session status. |
Operational Note
Kentucky's licensure and CON functions sit in the same cabinet, and the licensure regulation is drafted to relate expressly to the CON statutes. Treat the two as a single sequenced process rather than parallel tracks.
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ASC Specialty Hub
Louisiana
| Licensing authority | Louisiana Department of Health, Health Standards Section, Bureau of Health Services Financing. Statutory authority at R.S. 36:254 and R.S. 40:2131–2141. |
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| Licensure regulation | LAC Title 48, Part I, Subpart 3, Chapter 45 — Ambulatory Surgical Center Minimum Licensing Standards. The chapter has been amended by rule, including provisions addressing surgical smoke plume. An expedited licensing process for healthcare facilities appears at LAC 48:I Chapter 41. |
| Facility definition | An ASC is a distinct entity wholly separate and clearly distinguishable from any other healthcare facility or office-based physician practice. It shall be composed of at least two operating rooms and/or procedure rooms, with an organized medical staff of physicians and permanent facilities equipped and operated primarily to perform surgical procedures. It provides continuous physician and professional nursing services whenever a patient is present but does not provide services or accommodations for overnight stay. |
| Accreditation and Medicare certification | All licensed ASC facilities seeking initial Medicare certification must apply to one of the following accreditation organizations for an initial deemed status Medicare survey: The Joint Commission, AAAHC, AAAASF, or the American Osteopathic Association. After the survey, the Health Standards Section must receive a copy of the deemed status award letter. |
| Compliance transition | Licensed ASCs are given one year from the date of promulgation of a final rule to comply with all of its provisions. |
| Need review | Louisiana is a non-CON jurisdiction for ambulatory surgery under the certificate of need scan consulted. Confirm no successor review requirement applies. |
| Medicare prior authorization | Not a WISeR state. Not an ASC Prior Authorization Demonstration state. |
| State utilization review law | Gold carding statute active. AI-in-utilization-review legislation has been proposed, including a provision prohibiting the use of AI in any subsequent review of an adverse determination that used AI, requiring independent human judgment before an adverse medical necessity determination, and subjecting AI systems to inspection and audit by the insurance commissioner. Confirm enactment status. |
Operational Note
Louisiana requires a minimum of two operating or procedure rooms for ASC status. A single-room facility does not meet the state definition, which affects both licensure eligibility and the entity structure available to a solo or small-group practice.
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ASC Specialty Hub
Mississippi
| Licensing authority | Mississippi State Department of Health. Statutory authority at Miss. Code Ann. § 41-75-1 et seq., with licensure provisions at § 41-75-13. |
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| Licensure regulation | Minimum Standards of Operation for Ambulatory Surgical Facilities, promulgated by the Mississippi State Department of Health. |
| Separate premises | A separate license is required for ambulatory surgical facilities maintained on separate premises even under the same management; separate licenses are not required for multiple buildings on the same premises. |
| License term | Each license expires on June 30 following the date of issuance. |
| Enforcement | After notice and opportunity for a hearing, the Department is authorized to deny, suspend, or revoke a license, with an opportunity for a fair hearing provided to every applicant or licensee. |
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| Need review | Mississippi maintains a certificate of need program administered by the Mississippi State Department of Health. Confirm current thresholds and ambulatory surgery applicability with the Department. |
| Medicare prior authorization | Not a WISeR state. Not an ASC Prior Authorization Demonstration state. |
| State utilization review law | No AI-in-utilization-review enactment identified in the sources consulted. |
Operational Note
The June 30 uniform license expiration means renewal timing in Mississippi is not keyed to the anniversary of initial licensure. Calendar it against the fixed date rather than against an issue date.
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ASC Specialty Hub
North Carolina
| Licensing authority | Division of Health Service Regulation, under rules adopted by the North Carolina Medical Care Commission. Rulemaking authority at N.C. Gen. Stat. §§ 131E-147 and 131E-149. |
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| Licensure regulation | 10A NCAC Subchapter 13C, Licensing of Ambulatory Surgical Facilities. Requirements for issuance of license at 10A NCAC 13C .0202. Design and construction rules at 10A NCAC 13C .1401–.1403 were amended to adopt the Facility Guidelines Institute guidelines for ambulatory surgical center facilities; .1404 addresses equivalencies. Rules are subject to periodic review and expiration under G.S. 150B-21.3A. |
| Accreditation deeming | An ambulatory surgery facility is deemed to meet licensure requirements if accredited by The Joint Commission, AAAHC, or AAAASF. Accreditation does not exempt the facility from statutory or rule requirements for licensure, nor does it prohibit the Department from conducting inspections to determine compliance. |
| Construction approval | Schematic plans and specifications and final plans and specifications must be submitted to the Division for approval before construction begins; approval of construction documents must be obtained prior to licensure. Design and construction must comply with the Subchapter, the North Carolina State Building Code, and local municipal codes. |
| Sequence to licensure | The established procedure is: review the State Medical Facilities Plan to determine demonstrated need; obtain a certificate of need; obtain construction approval; then apply for and obtain a license and Medicare or Medicaid certification. |
| Need review | Certificate of need, driven by the annual State Medical Facilities Plan. North Carolina has been progressively narrowing its CON program through legislation adjusting expenditure thresholds and exempting facility types; confirm current ambulatory surgery applicability and thresholds. |
| Medicare prior authorization | Not a WISeR state. Not an ASC Prior Authorization Demonstration state. |
| State utilization review law | No AI-in-utilization-review enactment identified in the sources consulted. |
Operational Note
North Carolina sequences need review, construction approval, and licensure strictly. Construction approval must precede licensure, and CON must precede construction. A development schedule that assumes any parallelism among the three will slip.
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ASC Specialty Hub
South Carolina
| Licensing authority | South Carolina Department of Public Health (DPH), following the restructuring of the former Department of Health and Environmental Control. No person or entity may establish, operate, maintain, or advertise itself as an ambulatory surgical facility without first obtaining a license, and an unlicensed party determined to be providing services must cease operation immediately. |
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| Licensure regulation | Standards for Licensing Ambulatory Surgical Facilities — historically Regulation 61-91 and now also published as Regulation 60-91 following the agency restructuring. Amendments approved by joint resolution of the General Assembly in May 2024, signed May 21, 2024, and effective on publication in the State Register. Confirm the current regulation number and text with DPH. |
| Facility definition | A facility organized and administered for the purpose of performing surgical procedures and/or endoscopy for which patients are scheduled to arrive, receive surgery, and be discharged on the same day. The owner or operator must make the facility available to other providers comprising an organized professional staff — an open medical staff. The definition does not apply to a facility used as an office or clinic for the private practice of licensed healthcare professionals. |
| Indigent and charity care | Any facility established or constructed after May 16, 2023 that did not require a certificate of need must provide indigent and charity care as described in the regulation. Non-compliance results in a monetary penalty measured by the difference between the services required and those provided. |
| Scope restrictions | An ambulatory surgical facility license is not required for and will not be issued to certain categories, including ambulatory surgical services provided in licensed hospitals, which remain within the purview of R.61-16. The regulation also restricts the performance of abortions in an ambulatory surgical facility absent additional licensure. |
| Change reporting | Application or written notice is required for the addition or replacement of a surgical suite or any part of one, the deletion of operating or procedure rooms, and changes in facility name or address. |
| Exceptions | The Department has authority to make exceptions to the licensing standards where patient health, safety, and well-being are not compromised and the standard is not specifically required by statute. |
| Need review | Act 20 of 2023 (S. 164), signed May 2023, partially repealed the State Certification of Need and Health Facility Licensure Act (S.C. Code §§ 44-7-110 to 44-7-230) and removed ambulatory surgery facilities from the CON program. The CON program continues for other facility types. |
| Medicare prior authorization | Not a WISeR state. Not an ASC Prior Authorization Demonstration state. |
| State utilization review law | No AI-in-utilization-review enactment identified in the sources consulted. |
Operational Note
South Carolina traded CON for two conditions that are easy to underestimate: an open medical staff obligation, and an indigent and charity care obligation with a monetary penalty for shortfall, applying to facilities established after May 16, 2023 that did not require a CON. Both belong in the pro forma, not the compliance manual.
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ASC Specialty Hub
Tennessee
| Licensing authority | Tennessee Department of Health, Board for Licensing Health Care Facilities. Authority at T.C.A. §§ 4-5-202, 4-5-204, 68-11-202, 68-11-204, 68-11-206, 68-11-209, and 68-11-216. |
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| Licensure regulation | Rules of the Tennessee Department of Health, Chapter 1200-08-10, Standards for Ambulatory Surgical Treatment Centers — including admissions, discharges, and transfers at 1200-08-10-.05. Original rule filed 1977; repealed and replaced in 1992 and again in 2000, with subsequent amendments. Confirm the current effective text. |
| Facility definition and stay limit | An ambulatory surgical treatment center is any institution, place, or building devoted primarily to the maintenance and operation of a facility for the performance of surgical procedures. Such facilities shall not provide beds or other accommodations for a stay exceeding twelve hours, provided that the stay may be extended for an additional twelve hours where deemed necessary by the attending physician, the facility medical director, or the anesthesiologist for observation or recovery — but in no event shall the length of stay exceed twenty-four hours. Patients must be discharged in an ambulatory condition without danger to continued well-being. |
| Transfer agreement | Each ASTC must have a written transfer agreement with a local hospital. |
| Plan of correction | The Licensing Division approves a center's plan to correct deficiencies identified during an on-site survey conducted by the Survey Division or its designee. |
| Need review | Tennessee repealed the certificate of need requirement for ambulatory surgical centers. Following the repeal, non-hospital-affiliated ASCs must participate in the state's Medicaid program (TennCare) and provide a comparable level of care to TennCare enrollees and charity cases as hospital-based ASCs. The state's CON framework continues for other facility types. |
| Medicare prior authorization | ASC Prior Authorization Demonstration Phase 1 state. Requests accepted from January 5, 2026 for dates of service on or after January 19, 2026. Not a WISeR state. |
| State utilization review law | No AI-in-utilization-review enactment identified in the sources consulted. |
Operational Note
Tennessee's twelve-hour base stay with a twelve-hour extension is stricter at the front end than the federal 24-hour expectation and requires a named clinical decision-maker to authorize the extension. Build the extension authorization into the recovery workflow and document who made it, because it is a licensure element and not merely a clinical one. Note also that the TennCare participation condition attached to CON repeal is a contracting obligation, not just a policy preference.
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ASC Specialty Hub
Virginia
| Licensing authority | Virginia Department of Health, Office of Licensure and Certification, under the State Health Commissioner. Va. Code § 32.1-124 requires all general hospitals and outpatient surgical hospitals to obtain a license unless specifically exempted. Operating without a license is a Class 6 felony. |
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| Facility category | Virginia does not use an "ambulatory surgery center" licensure category. Facilities are licensed as hospitals and classified as general hospitals or outpatient surgical hospitals under 12VAC5-410-50, using the definitions at 12VAC5-410-10 and the statutory definition at Va. Code § 32.1-123. |
| Licensure regulation | 12VAC5-410, Regulations for the Licensure of Hospitals in Virginia. Part IV contains the organization, operation, and design standards specific to outpatient surgical hospitals, including medical staff requirements at 12VAC5-410-1180. Hospital outpatient ambulatory care is addressed at 12VAC5-410-470, which directs freestanding outpatient surgical hospitals to Part IV. License renewal conditions at 12VAC5-410-70. |
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| Separate premises | A separate license is required for hospitals maintained on separate premises even under the same management. |
| Accreditation presumption | The Office of Licensure and Certification may presume that an accredited and Medicare-certified hospital generally meets specified regulatory requirements, provided the facility supplies the most current accreditation survey findings on request and notifies OLC within ten days of any notice of revocation or denial of accreditation. |
| Need review | Certificate of Public Need (COPN), administered by the State Health Commissioner. Rules at 12VAC5-220-10 et seq. General surgical services is among the project categories requiring a COPN. No COPN may issue unless the Commissioner determines that a public need for the project has been demonstrated. |
| Medicare prior authorization | Not a WISeR state. Not an ASC Prior Authorization Demonstration state. |
| State utilization review law | Prior authorization reform legislation enacted in 2026. Confirm the operative decision timelines and effective date. |
Operational Note
Virginia's classification of ASCs as outpatient surgical hospitals has consequences well beyond nomenclature. Contract language, payer credentialing, corporate documents, and insurance policies drafted around an "ambulatory surgery center" concept may not map cleanly onto the Virginia license, and the felony exposure for unlicensed operation makes the classification question one to resolve before, not after, the first case.
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ASC Specialty Hub
West Virginia
| Licensing authority | West Virginia licensure of ambulatory health care facilities and ambulatory surgical facilities is required under W. Va. Code § 16B-3-1. No person or entity may establish, conduct, or maintain an ambulatory health care facility, an ambulatory surgical facility (freestanding or operated in connection with a hospital), or an extended care facility operated in connection with a hospital, without first obtaining a license. Only one license is required where a party operates any combination of these facility types at the same location. Federally operated facilities are exempt. |
|---|---|
| Facility definition | Under the certificate of need article, an "ambulatory surgical facility" is a facility not physically attached to a health care facility that provides surgical treatment to patients not requiring hospitalization. |
| Need review | Certificate of need under W. Va. Code Article 2D (§ 16-2D-1 et seq.), historically administered by the West Virginia Health Care Authority (§ 16-29B-1 et seq.). The statute contemplates exemptions and determinations of reviewability, and expressly addresses the acquisition by a hospital of a physician practice group that owns an ambulatory surgical center. Private office practices owned or operated by health professionals, and ambulatory health care facilities offering laboratory or diagnostic imaging services, receive specified treatment. Confirm the current administering body, as West Virginia has reorganized its health agencies and the certificate of need statute has been the subject of repeated amendment. |
| CON application track | The Authority has historically used an Ambulatory Care Center application with an expedited review pathway. Hospital-based dependent outpatient surgery facilities with at least four operating suites have been reviewable as ambulatory surgery centers where associated costs exceed the CON threshold; the definition excludes the legally authorized practice of surgery in private offices. |
|---|---|
| Medicare prior authorization | Not a WISeR state. Not an ASC Prior Authorization Demonstration state. |
| State utilization review law | Gold carding statute active. Confirm the qualifying threshold, look-back period, and exemption duration. |
Operational Note
West Virginia's CON statute has been amended repeatedly and the state has restructured its health agencies. Both the administering body and the current exemption categories should be confirmed directly rather than taken from any secondary compilation, including this one.
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Volume 2 Comparative Summary
| State | Licensure citation | Need review | Medicare PA |
|---|---|---|---|
| Alabama | Ala. Admin. Code ch. 420-5-2; Code of Ala. § 22-21-20 et seq.; ADPH | CON — confirm current body and thresholds | -- |
| Arkansas | Rules for Hospitals and Related Institutions; 20 CAR § 41-138; ADH | Non-CON for ambulatory surgery | -- |
| Florida | Ch. 395 Pt. I and Ch. 408 Pt. II Fla. Stat.; F.A.C. ch. 59A-5; AHCA | CON rolled back; not applicable to ambulatory surgery | ASC Demo Phase 1 |
| Georgia | Ga. Comp. R. & Regs. ch. 111-8-4; permit, not license; DCH | CON — O.C.G.A. § 31-6; single-specialty exemptions | ASC Demo Phase 1 |
| Kentucky | KRS 216B.105, 216B.042; 902 KAR 20:106; CHFS | CON — KRS ch. 216B | -- |
| Louisiana | R.S. 40:2131–2141; LAC 48:I ch. 45; LDH Health Standards Section | Non-CON for ambulatory surgery | -- |
| Mississippi | Miss. Code Ann. § 41-75-1 et seq.; Minimum Standards; MSDH | CON — MSDH | -- |
| North Carolina | G.S. 131E-147, 131E-149; 10A NCAC 13C; DHSR / Medical Care Commission | CON — State Medical Facilities Plan | -- |
| South Carolina | R.61-91 / R.60-91, Standards for Licensing Ambulatory Surgical Facilities; DPH | ASCs removed from CON by Act 20 of 2023 | -- |
| Tennessee | T.C.A. § 68-11-202 et seq.; Rule ch. 1200-08-10; Board for Licensing Health Care Facilities | ASC CON repealed; TennCare participation condition | ASC Demo Phase 1 |
| Virginia | Va. Code §§ 32.1-123, 32.1-124; 12VAC5-410 Part IV; VDH OLC | COPN — 12VAC5-220 | -- |
| West Virginia | W. Va. Code § 16B-3-1 | CON — W. Va. Code art. 2D; confirm current body | -- |
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Regional Operating Observations
- Certificate of need reform is the defining regional dynamic. South Carolina removed ambulatory surgery from CON entirely (Act 20 of 2023); Tennessee repealed the ASC CON requirement; Georgia created single-specialty exemptions in 2024; Florida rolled back its program; North Carolina has narrowed its own. Arkansas and Louisiana were already outside CON for ambulatory surgery.
- Deregulation came with conditions in two states. South Carolina attached an open medical staff requirement and an indigent and charity care obligation with a monetary penalty; Tennessee attached TennCare participation and a comparable level of care commitment. Neither is a compliance footnote — both are financial model inputs.
• Three of the twelve are ASC Prior Authorization Demonstration Phase 1 states — Florida, Georgia, and Tennessee. None is a WISeR state.
- Facility nomenclature varies more here than anywhere else. Georgia issues a permit; Virginia licenses outpatient surgical hospitals; Arkansas licenses within the hospital rules; Alabama uses ambulatory surgical treatment facility; Tennessee uses ambulatory surgical treatment center. Contract and credentialing language should track the state's own term.
- Length-of-stay limits are not uniform. Tennessee caps at twelve hours extendable to twenty-four with a named clinical authorization; Louisiana prohibits overnight accommodation; Arkansas limits to short-term non-overnight rooms. The federal 24-hour expectation is a ceiling, not a floor.
- Accreditation deeming is broad in this region. North Carolina deems accredited facilities to meet licensure requirements; Florida deems accredited facilities out of routine survey; Virginia applies an accreditation presumption; Louisiana requires accreditation-based deemed status surveys for initial Medicare certification.
- Alabama and Georgia both saw material regulatory movement in 2024–2025. Alabama amended its ASC chapter twice in 2025; Georgia's CON exemptions took effect and its AI utilization review statute takes effect January 1, 2027.
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Key Takeaways
- Southeastern CON has changed materially since 2023 in at least five states. Re-verify before relying on any development analysis older than that.
- Where CON was repealed, conditions were frequently substituted — open medical staff, charity care, or Medicaid participation. Model them.
- Georgia's permit is service-classification-specific; adding a service line is a permit action.
- Virginia licenses ASCs as outpatient surgical hospitals, and unlicensed operation is a Class 6 felony.
- Tennessee's twelve-hour stay limit with a documented extension is stricter than the federal expectation.
- Louisiana requires at least two operating or procedure rooms to qualify as an ASC.
- Florida requires a 60-day advance change application for any change in operating room, procedure room, or recovery bed count.
- Every citation here is a starting point for primary research and counsel review.
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References
All references are primary or authoritative secondary sources. Blogs, AI-generated content, marketing websites, and non-authoritative sources are excluded by standard. Complete website addresses are provided.
- National Academy for State Health Policy. 50-State Scan of State Certificate-of-Need Programs, database updated December 12, 2025. Website: https://nashp.org/state-tracker/50-state-scan-of-state-certificate-of-need-programs/
- Centers for Medicare & Medicaid Services. Prior Authorization Demonstration for Certain Ambulatory Surgical Center (ASC) Services. Website: https://www.cms.gov/data-research/monitoring-programs/medicare-fee-service-compliance-programs/prior-authorization-pre-claim-review-initiatives/prior-authorization-demonstration-certain-ambulatory-surgical-center-services
- Centers for Medicare & Medicaid Services. Prior Authorization Demonstration for Certain Ambulatory Surgical Center Services — Frequently Asked Questions, December 23, 2025. Website: https://www.cms.gov/files/document/asc-demonstration-faqs.pdf
- Centers for Medicare & Medicaid Services, Center for Medicare and Medicaid Innovation. WISeR Model Provider and Supplier Operational Guide. Website: https://www.cms.gov/priorities/innovation/files/wiser-provider-supplier-guide.pdf
- Electronic Code of Federal Regulations. 42 CFR Part 416, Subpart C — Specific Conditions for Coverage for Ambulatory Surgical Services. Website: https://www.ecfr.gov/current/title-42/chapter-IV/subchapter-B/part-416/subpart-C
- Holland & Knight. States Continue Efforts to Regulate AI in Healthcare: A Review of Legislation Passed in 2026. Website: https://www.hklaw.com/en/insights/publications/2026/05/states-continue-efforts-to-regulate-ai-in-healthcare
- KFF. Regulation of AI in Prior Authorization and Claims Review: A Look at Federal and State Consumer Protections. Website: https://www.kff.org/patient-consumer-protections/regulation-of-ai-in-prior-authorization-and-claims-review-a-look-at-federal-and-state-consumer-protections/
- Georgetown University Center on Health Insurance Reforms. Prior Authorization Reform Heats Up. Website: https://chir.georgetown.edu/prior-authorization-reform-heats-up/
- GoHealthcare Practice Solutions Knowledge Center. Website: https://www.gohealthcarellc.com
- Alabama Department of Public Health. Rules of Alabama State Board of Health, Chapter 420-5-2, Ambulatory Surgical Treatment Facilities. Website: https://www.alabamapublichealth.gov/providerstandards/assets/ASCRules.pdf
- Alabama Legislature. Alabama Administrative Code Chapter 420-5-2. Website: https://admincode.legislature.state.al.us/api/chapter/420-5-2
- Arkansas Department of Health. Rules for Hospitals and Related Institutions in Arkansas. Website: https://healthy.arkansas.gov/wp-content/uploads/Hospital_Rules.pdf
- Code of Arkansas Rules. 20 CAR § 41-138, Ambulatory surgery centers. Website: https://codeofarrules.arkansas.gov/; =55241
- Florida Agency for Health Care Administration. Ambulatory Surgical Center. Website: https://ahca.myflorida.com/health-quality-assurance/bureau-of-health-facility-regulation/hospital-outpatient-services-unit/ambulatory-surgical-center.html
- Florida Administrative Code Chapter 59A-5, Ambulatory Surgical Center Licensure. Website: https://flrules.org/gateway/ChapterHome.asp?Chapter=59a-5
- Georgia Secretary of State. Ga. Comp. R. & Regs. Subject 111-8-4, Ambulatory Surgical Treatment Centers. Website: https://rules.sos.ga.gov/gac/111-8-4
- Georgia Secretary of State. Ga. Comp. R. & Regs. Subject 111-2-2, Certificate of Need. Website: https://rules.sos.ga.gov/gac/111-2-2
- Kentucky Legislative Research Commission. 902 KAR 20:106, Operation and services; ambulatory surgical center. Website: https://apps.legislature.ky.gov/law/kar/titles/902/020/106/
- Louisiana Department of Health, Health Standards Section. Ambulatory Surgical Center (ASC) — Minimum Licensing Standards, LAC 48:I Chapter 45. Website: https://ldh.la.gov/health-standards-section/ambulatory-surgical-center-asc
- Mississippi State Department of Health. Minimum Standards of Operation for Ambulatory Surgical Facilities. Website: https://msdh.ms.gov/page/resources/109.pdf
- North Carolina Office of Administrative Hearings. 10A NCAC Subchapter 13C, Licensing of Ambulatory Surgical Facilities. Website: http://reports.oah.state.nc.us/ncac/title%2010a%20-%20health%20and%20human%20services/chapter%2013 %20-%20nc%20medical%20care%20commission/subchapter%20c/subchapter%20c%20rules.pdf
- North Carolina Division of Health Service Regulation. Establish an Ambulatory Surgical Facility. Website: https://info.ncdhhs.gov/dhsr/ahc/floamsu.htm
- South Carolina Department of Public Health. Ambulatory Surgical Facilities — Standards for Licensing. Website: https://dph.sc.gov/professionals/healthcare-quality/licensed-facilities-professionals/ambulatory-surgical-facilities
- South Carolina Department of Public Health. Certificate of Need (CON) — S.C. Code §§ 44-7-110 to 44-7-230. Website: https://dph.sc.gov/professionals/healthcare-quality/certificate-need-con
- Maynard Nexsen. New Regulatory Updates for SC Ambulatory Surgery Centers: The Impact of CON Repeal, DHEC Changes, and Ongoing Considerations. Website: https://www.maynardnexsen.com/publication-ambulatory-surgery-centers-sc-regulatory-updates-and-other-considerations
- Tennessee Department of Health. Rules Chapter 1200-08-10, Standards for Ambulatory Surgical Treatment Centers. Website: https://publications.tnsosfiles.com/rules/1200/1200-08/1200-08-10.20190606.pdf
- Virginia Administrative Code. 12VAC5-410, Regulations for the Licensure of Hospitals in Virginia. Website: https://law.lis.virginia.gov/admincodefull/title12/agency5/chapter410/
- Virginia Department of Health. Certificate of Public Need Program. Website: https://www.vdh.virginia.gov/licensure-and-certification/the-certificate-of-public-need-program/
- West Virginia Code § 16B-3-1. Website: https://code.wvlegislature.gov/16B-3-1/
- Holland & Knight. A Review of Recent State and Federal Changes to the Ambulatory Surgical Center Regulatory Landscape. Website: https://www.hklaw.com/en/insights/publications/2025/10/a-review-of-recent-state-and-federal-changes-to-the-ambulatory
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Related GoHealthcare Resources
- ASC Specialty Hub — the other twelve pages listed in the Page Index at the front of this document, available in the GoHealthcare Knowledge Center at https://www.gohealthcarellc.com
- GoHealthcare MSK Specialty Procedure Library™ — procedure-specific operational guides across interventional pain, spine surgery, neuromodulation, orthopedic surgery, and peripheral nerve procedures.
- GoHealthcare Revenue Cycle Knowledge Center — detailed reimbursement methodology, fee schedule analysis, payment rate modeling, edit tables, and revenue cycle analytics, which are intentionally outside the scope of the Procedure Library.
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Document History
| Version | Date | Summary of changes | Prepared by |
|---|---|---|---|
| 1.0 | August 3, 2026 | Initial publication. Volume 2 of the four-volume ASC State Regulatory Profiles series. Citation-level profiles for twelve South and Southeast states, including South Carolina's removal of ambulatory surgery from certificate of need under Act 20 of 2023 with substituted open medical staff and indigent care conditions; Tennessee's ASC CON repeal with TennCare participation conditions and its twelve-hour stay limit; Georgia's service-classification permit structure and 2024 single-specialty CON exemptions; Virginia's licensure of ASCs as outpatient surgical hospitals; Florida's accreditation deeming and 60-day change application requirement; and Louisiana's two-room minimum. Includes a comparative summary and regional operating observations. | GoHealthcare Practice Solutions, under the leadership of Pinky Maniri, Founder and Chief Executive Officer |
On Document Currency
This page carries a Publication Date and a Document Version rather than a scheduled review date. GoHealthcare's editorial standard is that a published review date becomes a public commitment the moment it lapses. Currency is communicated through version releases and through the verification standards stated throughout this document.
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ASC Specialty Hub
Educational Disclaimer and Terms of Use
This document is published by GoHealthcare Practice Solutions, under the leadership of Pinky Maniri, Founder and Chief Executive Officer. The following terms govern its use.
- Purpose and limitation of purpose. This document is provided solely for educational and operational reference purposes. It is intended to help healthcare professionals understand the operational, documentation, payer, coding, compliance, and reimbursement environment surrounding ambulatory surgical center services. It is not a clinical practice guideline, a procedural technique manual, a physician training resource, an accreditation manual, or a substitute for the specialty society guidance, clinical textbooks, and procedural training on which clinical practice properly depends.
- No professional relationship. Use of this document does not create a physician-patient relationship, an attorney-client relationship, a consulting engagement, or any other professional relationship between the reader and GoHealthcare Practice Solutions or any of its personnel. No confidential relationship is formed by reading, downloading, distributing, or relying upon this document.
- Not medical advice. Nothing in this document constitutes medical advice or a recommendation regarding the care of any individual patient. All clinical decisions, including patient selection, site-of-service determination, procedure selection, and discharge, remain the exclusive responsibility of the treating physician exercising independent clinical judgment in the context of the individual patient's circumstances.
- Not legal advice. Nothing in this document constitutes legal advice or an opinion on the lawfulness of any arrangement, structure, policy, billing practice, or course of conduct. Matters involving the Anti-Kickback Statute, the Physician Self-Referral Law (Stark), the False Claims Act, the Civil Monetary Penalties Law, state fraud and abuse law, state licensure and certificate of need requirements, corporate practice of medicine, ownership and investment structures, contracting, employment, and privacy should be reviewed by qualified healthcare counsel before implementation.
- Coding limitations and compliance responsibility. Coding content in this document is a general operational orientation only. It does not constitute coding advice, certification, or a guarantee of payment. Code selection, modifier application, and claim submission are the responsibility of the submitting entity. Inaccurate or unsupported claim submission may carry consequences under the False Claims Act, the Civil Monetary Penalties Law, the Anti-Kickback Statute, and the Physician Self-Referral Law, among other authorities. All coding must be supported by the medical record and verified against current official code descriptors and the applicable payer's current policy.
- No guarantee of coverage, payment, or authorization outcome. Nothing in this document guarantees that any payer will authorize any service, cover any procedure, or pay any claim. Coverage determinations, authorization decisions, and payment outcomes rest with the applicable payer under its own policies and the governing contract.
- Currency limitations. Coverage policies, national and local coverage determinations, payment rates, conversion factors, covered procedures lists, quality reporting requirements, correct coding edits, utilization management criteria, demonstration and model parameters, state statutes and regulations, and applicable law change frequently and often without broad notice. Information in this document reflects sources available as of the Publication Date and may become inaccurate at any time thereafter. Every material fact should be independently verified against the current primary source before reliance.
- Payer content and artificial intelligence processing. Summaries of payer coverage policies and utilization management criteria in this document are original synthesis prepared for educational purposes and are not reproductions of payer manuals or proprietary criteria sets. Payer clinical policy content may be subject to use restrictions, including restrictions on reproduction, redistribution, and ingestion into artificial intelligence systems. Readers who intend to process payer-derived content through artificial intelligence systems should confirm the applicable license terms and obtain legal review before doing so.
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- payment figures were verified against primary sources during preparation. Notwithstanding that verification, readers must independently confirm all information before operational, billing, contracting, clinical, or compliance reliance.
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- Intellectual property and permitted use. This document and the GoHealthcare MSK Specialty Procedure Library™ are the property of GoHealthcare Practice Solutions. It may be read, printed, and shared internally within a healthcare organization for educational purposes with attribution intact. It may not be modified, resold, republished, incorporated into a commercial product, or presented as the work of another party.
- Third-party trademarks. CPT® is a registered trademark of the American Medical Association. All other product names, brand names, company names, and trademarks referenced are the property of their respective owners. Reference to any organization, payer, utilization management entity, device manufacturer, accreditation body, or product is for identification and educational purposes only and does not imply endorsement, affiliation, sponsorship, or any relationship between that party and GoHealthcare Practice Solutions.
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- Corrections and contact. GoHealthcare Practice Solutions welcomes correction. If you identify an error, an outdated citation, or a coverage position that has changed, please contact GoHealthcare Practice Solutions through https://www.gohealthcarellc.com so that it can be evaluated and, where warranted, corrected in a subsequent version and reflected in the Document History.
Educational Disclaimer — Summary
This document was developed by GoHealthcare Practice Solutions, under the leadership of Pinky Maniri, Founder and Chief Executive Officer — MSc, CRCR, CSAPM, CSPPM, CSBI, CSPR, CSAF, Certified in Healthcare A.I. Governance.
It is educational and operational reference material only. It does not replace physician clinical judgment, payer policy review, legal advice, accreditation standards, or official CMS guidance. Coverage policies, coding guidance, and reimbursement requirements must always be verified with the applicable payer and current regulatory sources.
GoHealthcare Practice Solutions — a national Musculoskeletal Specialty Management Services Organization. Website: https://www.gohealthcarellc.com
Back to page navigation ↑Strengthen Ambulatory Surgery Center Operations Across the Entire Episode
GoHealthcare Practice Solutions supports ambulatory surgery centers and musculoskeletal organizations across patient access, prior authorization, clinical documentation, coding alignment, denial prevention, revenue cycle management, compliance, performance analytics, and healthcare AI governance.
Developed by
Pinky Maniri
MSc, CRCR, CSAPM, CSPPM, CSBI, CSPR, CSAF, Certified in Healthcare A.I. Governance
Founder and Chief Executive Officer, GoHealthcare Practice Solutions