Ambulatory surgery centers expected to collect about $380.1 million in patient deposits in 2025. They collected $254.7 million. That leaves roughly $125.4 million in deposits that did not come in.
The figures come from a 2026 industry report covering 682 ASCs in 45 states and nearly 4.8 million unique patient visits, as reported by Becker's ASC on October 2, 2026. The deposit collection rate is moving in the right direction, from 63% in 2023 to 65% in 2024 and 67% last year. Slowly, though. At this pace, a third of expected deposits still goes uncollected.
The same data shows where the leak starts. Insurance verification was completed on 83% of cases in 2025. When prior authorization was required, it was completed on only 32% of cases. Both numbers live at the front end of the revenue cycle, which is exactly where a deposit is won or lost.
Key Takeaways
ASCs in the report expected about $380.1 million in patient deposits in 2025 and collected $254.7 million, a collection rate of about 67%.
That rate has improved two points a year, from 63% in 2023 to 65% in 2024 to 67% in 2025.
Insurance verification was completed on 83% of cases in 2025, up from 77% in 2023.
When prior authorization was required, it was completed on 32% of cases in 2025, up from 21% in 2023.
Pain and spine centers trail the field on net collections at 54% and 73%, against an overall average of 87%.
The report recommends sending patients an accurate estimate ideally one to two weeks before the date of service.
How big is the patient deposit gap?
Big enough to notice on any single center's books. The 682 centers in the report expected about $380.1 million in deposits and collected $254.7 million. The difference, roughly $125.4 million, is money that was scheduled to arrive before or at the date of service and did not.
Some of it may be recovered later through statements and follow-up. That recovery costs staff time, postage and patience, and every month a balance ages, the odds of collecting it drop. A deposit collected up front costs almost nothing to process. A balance chased after surgery is a different story.
Why does the collection rate stay near two-thirds?
Partial payments are part of it. According to the report, 47% of reimbursements were partial payments and only 26% were paid in full. Patients who are surprised by what they owe tend to pay some of it, not all of it.
The improvement from 63% to 67% over two years shows centers are working on the problem. More are adopting financial clearance tools such as automated patient estimates and online payments, according to the report. But four points in two years is incremental. Centers that want a step change usually need to fix the process, not just add a payment link.
What does prior authorization have to do with deposits?
Everything, because both depend on knowing the patient's coverage before the case. Insurance verification reached 83% of cases in 2025, up from 77% in 2023. Prior authorization, when required, was completed on 32% of cases, up from 21%.
A center cannot quote an accurate patient responsibility without confirmed benefits. It cannot protect the claim without a valid authorization. When either step is skipped or finished late, the estimate is a guess, the deposit request is softer, and the claim carries denial risk that shows up weeks later.
How do cancellations fit into the picture?
ASCs in the report canceled 647,287 cases in 2025, about 20% of everything scheduled. That rate has held between 20% and 21% since 2023.
Most cancellations come from patient decisions or provider changes. Among the 317,382 cancellations with a recorded reason, insurance issues accounted for 4.7% and financial reasons for another 2.3%. Together that is roughly 22,000 cases lost to coverage or cost questions, the kind a clean front end is designed to answer before the patient has time to walk away.
Which specialties are under the most pressure?
Pain management and spine. The report puts overall ASC net collection rates at 87% in 2025, up from 81% in 2024. Pain centers sat at 54% and spine centers at 73%.
Net collection rate is a different measure from the deposit rate, but the message lines up. In our work with specialty practices, the ones with heavy authorization requirements, frequent payer policy changes and higher patient cost sharing feel front-end gaps first. For pain practices in particular, the distance between 54% and 87% is the difference between a healthy center and a stressed one.
What does strong financial clearance look like?
The report lays out a practical baseline. Verify insurance at least twice: once immediately after accepting the case and again the morning of the procedure. Give patients an accurate financial estimate before the date of service, ideally one to two weeks out, so they can plan for it.
Add a clear deposit request with an easy way to pay, and track authorization status as a hard stop, not a reminder. None of this is exotic. It just has to happen on every case, which is where most teams fall short.
What This Means for Your Practice
If your center's deposit collection rate looks like the industry's, about one in every three expected deposit dollars is not arriving on time. Start by measuring it. Pull expected versus collected deposits by month and by specialty, and compare your authorization completion rate on cases that required one.
Then work backward from the date of service. Benefits verified when the case is booked. Verified again the morning of surgery. Authorization confirmed before the patient is scheduled into an OR slot. An estimate in the patient's hands one to two weeks out, with a simple way to pay.
Pain management and spine programs should move first. Their net collection rates leave the most room to recover, and their payer rules change often enough that a manual front end rarely keeps up.
Frequently Asked Questions
Find Out What Your Center Is Leaving Uncollected
Cosentus helps ASCs and specialty practices tighten the front end of the revenue cycle, from benefits verification and prior authorization to patient estimates and deposit collection. Want to know what your center is leaving uncollected? Talk to our team at cosentus.com/contact