Freestanding Surgical Outpatient Facilities (FSOF)/ Ambulatory Surgical Centers (ASC)

  • This page is designed to assist providers through the state licensure and federal certification processes, as well as provide additional resources to maintain compliance.

State Licensing

  • State licensing is required for freestanding surgical outpatient facilities (FSOF).

    A state licensure application (BCHS-HFD-100) is required to (Licensure fee required):

    • Begin operation of a new FSOF ($2,000 application fee/invoice required)
    • Change ownership (CHOW) of an existing FSOF

    A state licensure application is also required to (No fee required):

    • Change name of facility
    • Change location of facility


    • Fee: $500
    • Annual renewal invoices sent in June of each year.
    • License renewals must be paid online no later than July 31st.

    Other state agencies may require approval prior to licensing actions. Contact the following state agencies to determine whether their approval is required.

    Certificate of Need
    Michigan Department of Health & Human Services (MDHHS)
    Lewis Cass Building, 3rd Floor
    320 S. Walnut Street
    Lansing, MI 48913
    Phone: 517-241-3344

    Health Facilities Engineering Section
    Michigan Department of Licensing and Regulatory Affairs (LARA)
    PO Box 30664
    Lansing, MI 48909
    Phone: 517-241-3408

    Bureau of Fire Services
    Michigan Department of Licensing and Regulatory Affairs (LARA)
    3101 Technology Boulevard, Suite H
    PO Box 30700
    Lansing, MI 48909
    Phone: 517-335-5804

Federal Certification

  • Surgery centers may apply for certification to participate in the Medicare/Medicaid programs.  The Centers for Medicare and Medicaid Services (CMS) contracts with LARA to evaluate compliance with the federal regulations by conducting certification surveys and complaint investigations.  Surgery centers must be licensed with the State of Michigan before Medicare certification is approved.

    For initial certification or change of ownership:

    • Complete Provider Enrollment Application (CMS-855B) and submit to Medicare Administrative Contractor (MAC)/Fiscal Intermediary (FI)
    • Complete and submit to BCHS:
      • Complete Ambulatory Surgical Center Request for Certification in Medicare (CMS-377)
      • Two (2) signed originals Health Insurance Benefits Agreement-Ambulatory Surgical Center (CMS-370)

    Contact Accrediting Organization (AO) to schedule survey for initial certification


    For a change in administrator, please email the following:

    • Facility name, address, and provider # or state facility ID
    • New administrator full name
    • Effective start date of administrator

Contact Information

  • Michigan Department of Licensing & Regulatory Affairs
    Bureau of Community and Health Systems
    611 W. Ottawa Street
    PO Box 30664
    Lansing, MI 48909

    Main Line: 517-335-1980

    State Licensing
    Phone: 517-241-1970
    FAX: 517-241-3354

    Federal Certification
    Phone: 517-284-8953
    FAX: 517-241-2635