Ambulatory Surgical Facilities

Frequently Asked Questions

Who needs a license?

Effective January 1, 2012, all ambulatory surgical facilities (ASF) in Washington need to be licensed. The state laws relating to ambulatory surgical centers are in chapter 70.230 RCW.

What type of facility must be licensed as an ambulatory surgical facility under this statute?
  • A facility which is a distinct business entity; and
  • Provides specialty or multi-specialty outpatient surgical services, and either:
    • Plans to use general anesthesia, or
    • Operates for the primary purpose of providing specialty or multi-specialty outpatient surgical services.
How does the department define "primary purpose?"

The majority of income or patient visits for the facility are derived from the specialty or multi-specialty surgical services.

What does it mean to provide specialty or multi-specialty outpatient surgical services?

"Outpatient" means the patients are admitted and discharged within 24 hours. "Surgical services" are invasive medical procedures by a practitioner using a knife, laser, cautery, cryogenics or chemicals to remove, correct or facilitate the diagnosis or cure of a disease, process, injury or deformity.

What does "by a practitioner" mean in this statute?

The main function (i.e., "primary purpose") of at least one of your surgical suites is to provide specialty or multi-specialty outpatient surgical services.

What is a practitioner under this statute?

Practitioner is defined as any physician or surgeon licensed under 18.71 RCW, an osteopathic physician or surgeon licensed under 18.57 RCW, or a podiatric physician or surgeon licensed under 18.22 RCW.

Is my surgical practice exempt from ambulatory surgical facility licensure?

It's exempt if:

  • The surgical suite or procedure room is located inside a practitioner office, and
  • The primary purpose of the practitioner office isn't providing specialty or multi-specialty outpatient surgical services, and
  • Use of general anesthesia isn't a planned event in the suite or room.
If I don't qualify for an ambulatory surgical facility license, do I need to be licensed as a healthcare entity?

If you use medications in your facility and need a DEA registration, you must hold an active healthcare entity pharmacy license. If a facility paid for an ASF license in lieu of renewing the healthcare entity license, we'll transfer the payment submitted for the ASF license to cover the renewal fee for the healthcare entity license.

How do I switch from the ambulatory surgical facility license to a pharmacy healthcare entity license?

For those who qualify, to cancel your ambulatory surgical facility (ASF) license and apply for a healthcare entity license, you may download the application from healthcare entity application packet (PDF). Send us your application and include a letter explaining that you wish to cancel your ASF license and become licensed as a healthcare entity.

How do I get an ambulatory surgical facility application?

The ambulatory surgical facility application is on our website.