Ambulatory payment classification definition

Ambulatory payment classification or “APC” means an outpatient service or group of services for which a single rate is set. The services or groups of services are determined according to the typical clinical characteristics, the resource use, and the costs associated with the service or services.
Ambulatory payment classification means a reimbursement method that categorizes outpatient visits into groups according to the clinical characteristics, the typical resource use, and the costs associated with the diagnoses and the procedures performed. The groups are called Ambulatory Payment Classifications (APCs).
Ambulatory payment classification or “APC” means the system of classifying outpatient department (OPD) services reimbursed under the Medicare program prospective payment system for hospital outpatient services as set forth in 42 USC 1833 (t) as from time to time amended;

Examples of Ambulatory payment classification in a sentence

  • Ambulatory payment classification (APC) codes from the OPPS, for example, would not represent a fair, stable, and accurate means to account for indirect practice expense for the MFS due to lack of granularity.

  • Ambulatory payment classification (APC)(f) Entities requesting the PUDF must sign and complete the Data Use Agreement.

  • Subpart C—Basic Methodology for Deter- mining Prospective Payment Rates for Hospital Outpatient Services419.30 Base expenditure target for calendar year 1999.419.31 Ambulatory payment classification (APC) system and payment weights.419.32 Calculation of prospective payment rates for hospital outpatient services.

  • The department uses:(a) The RCC payment method to pay hospitals for hospi- tal services that are exempt from the diagnosis related group (DRG), per diem, ambulatory)) payment method for services exempt from the following payment methods:(a) Ambulatory payment classification (APC)((, maxi- mum allowable fee schedule, and per case payment methods.


More Definitions of Ambulatory payment classification

Ambulatory payment classification or "APC" means the classification system described in 42 CFR 419.31 that is the basis of Medicare's reimbursement system for outpatient hospital services.
Ambulatory payment classification or “APC” means the classification of clinically similar outpatient hospital services that can be expected to consume similar amounts of hospital resources and serves as one of the methods of payment under the Outpatient Prospective Payment System;

Related to Ambulatory payment classification

  • Ambulatory means the condition of a person who immediately and without aid of another is physically or mentally capable of traveling a normal path to safety, including the ascent and descent of stairs.

  • Clinical nurse specialist means a registered nurse with relevant post-basic qualifications and 12 months’ experience working in the clinical area of his/her specified post-basic qualification, or a minimum of four years’ post-basic registration experience, including three years’ experience in the relevant specialist field and who satisfies the local criteria.

  • Nonambulatory means a person who immediately and without the aid of another is not physically and mentally capable of traveling a normal path to safety, including the ascent and descent of stairs.

  • Substance Abuse Professional (SAP) means a qualified person who evaluates employees who have violated a DOT drug and alcohol regulation and makes recommendations concerning education, treatment, follow-up testing, and aftercare.

  • Esthetician means a person licensed under this chapter to engage in the practice of esthetics.

  • Specialist Physician means a licensed physician who qualifies as an attending physician and who examines a patient at the request of the attending physician or authorized nurse practitioner to aid in evaluation of disability, diagnosis, or provide temporary specialized treatment. A specialist physician may provide specialized treatment for the compensable injury or illness and give advice or an opinion regarding the treatment being rendered, or considered, for a patient’s compensable injury.

  • Double check valve assembly means an assembly composed of two single, independently acting, check valves including tightly closing shutoff valves located at each end of the assembly and suitable connections for testing the water tightness of each check valve.

  • Designated mental health professional means a mental health

  • Physical therapist assistant means an individual who is licensed/certified by a state and who assists the physical therapist in selected components of physical therapy.

  • Designated chemical dependency specialist means a person

  • Independent educational evaluation means an evaluation conducted by a qualified examiner who is not employed by the public agency responsible for the education of the child in question.

  • Ambulatory surgical center means any public or private State licensed and approved (whenever required by law) establishment with an organized medical staff of Physicians, with permanent facilities that are equipped and operated primarily for the purpose of performing Surgical Procedures, with continuous Physician services and registered professional nursing service whenever a patient is in the facility, and which does not provide service or other accommodations for patients to stay overnight.

  • Physical therapist means an individual who is licensed by a state to practice physical therapy.

  • Specialist means either a physician or other health care professional who practices in a specific area other than those practiced by primary care providers, or a properly licensed, certified or registered individual health care provider whose practice is limited to rendering mental health services. For purposes of cost-share, this definition of “specialist” does not apply to dentists. BCBSAZ does not require you to obtain an authorization or referral to see a specialist.