Ambulatory Payment Classification


Also found in: Acronyms.

Am·bu·la·to·ry Pay·ment Clas·sif·i·ca·tion

(APC) (am'byū-lă-tōr-ē pā'mĕnt klas'i-fi-kā'shŭn)
In U.S. medical care, a system for grouping outpatient services provided by hospitals on the basis of similarity of costs and clinical indications; used by the Centers for Medicare and Medicaid Services to set the rates at which it will reimburse hospitals for outpatient care.
References in periodicals archive ?
Among the changes, the proposal calls for setting the threshold for outlier payments at 2.75 times the ambulatory payment classification (APC) rate and setting a separate outlier threshold for community mental health centers that appear to receive disproportionately high outlier payments.
Smith & Nephew pic, Largo, FL and Advanced Tissue Sciences, La Jolla, CA announced that Dermagraft Human Fibroblast-Derived Skin Substitute has received an Ambulatory payment Classification (APC) pass-through code under the Hospital Outpatient Prospective Payment System from the Centers for Medicare & Medicaid Services (CMS - formerly HCFA).
We suspected that our manual methods sometimes resulted in missed charges related to Medicare's Ambulatory Payment Classification (APC) because we could not keep all codes up-to-date.
The MMA defined a SCOD as a drug or radiopharmaceutical used in hospital outpatient departments, covered by Medicare, and for which CMS has established a separate ambulatory payment classification (APC) group.
The proposal calls for setting the threshold for outlier payments at 2.75 times the ambulatory payment classification (APC) payment rate and setting a separate outlier threshold amount for community mental health centers that appear to have received disproportionately high outlier payments.
Consider the case of APC (ambulatory payment classification) reimbursement, where coding needs to be done:
Under this 2002 methodology, the copayment amount for each outpatient payment group of services, called an ambulatory payment classification (APC) group, could not increase from year to year, and the beneficiary coinsurance percentage would remain the same or decrease, eventually reaching 20 percent for each APC.
has launched APC Assistant, a Web-based version of OCExpert, a knowledge-based tool for the prevention and management of Ambulatory Payment Classification (APC) claims denials and rejections.

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