CMS Reintroduces Proposed Rule To Bundle Outpatient Service Payments For Follow-Up To Device Implantation

Starting January 2015, Medicare plans to revise its Ambulatory Classification Payment (APC) billing units for outpatient services associated with surgery . The plan is to move from APC billing units to Comprehensive APCs — bundles of outpatient services associated with surgery to implant high cost medical devices. Services for 39 device-dependent APC procedures—such as a pacemaker or knee joint replacement—would be covered by this change.

APCs are the main billing unit for the Medicare Hospital Outpatient Prospective Payment System (OPPS). The OPPS pays for outpatient services related to a Medicare Part A inpatient event that cannot be covered under . . .