What are ambulatory payment classifications (APCs)?
Ambulatory payment classifications (APCs) refer to the reimbursement system that applies to hospitals for the treatment of Medicare beneficiaries who receive medical care in the hospital outpatient setting. An outpatient is typically someone who comes to the hospital and is not admitted to the hospital as an inpatient. APCs are similar to Diagnosis Related Groups (DRG), the Medicare hospital inpatient reimbursement system, in that an episode of care is reimbursed at a fixed amount that is predetermined by the Centers for Medicare and Medicaid Services (CMS) for groups of services. A single patient may be assigned more than one APC code. Note: APC codes are not billing codes. (Please see below for information on billing.
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