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.