General Question for the Week of Decemeber 7, 2015

General Compliance Question of the Week


What is the C-APC used in the hospital OPPS?


The Centers for Medicare & Medicaid Services (CMS) first adopted the comprehensive ambulatory payment classifications (C-APC) in 2015. It defines the C-APC as the outpatient version of the diagnosis-related group (DRG) payment system, with one payment to cover all services provided during an outpatient encounter. This is a progression of CMS’s ever-intensifying move toward bundling payments for services instead of paying “per piece.”
Initially, C-APCs included predominantly invasive procedures such as cardiac catheterization and stenting, pacemaker and defibrillator placement, and general, gynecologic, and orthopedic procedures. For 2016, it created a C-APC for observation services.

Disclaimer: Every reasonable effort was made to ensure the accuracy of this information at the time it was published. However, due to the nature of industry changes over time we cannot guarantee its validity after the year it was published.