If you’re thinking of building your own ambulatory surgery center (ASC), don’t assume that obtaining a certificate of need is only a formality.

A group of Ronanoke Valley, Va. ophthalmologists know better. After getting approval from a regional review board, a Department of Health official said no.

Before you spend your money planning an ASC — these doctors had already spend $180,000 — carefully investigate what you need to prove that the ASC is necessary.