The Centers for Medicare and Medicaid Services (CMS) has developed Ambulatory Payment Classifications (APCs) as a method of payment for hospital outpatient services.
Each APC is composed of procedures which are similar in clinical intensity, resource utilization, and cost.
All services which are grouped under a specific APC result in an annually updated Medicare “prospective payment” for that particular APC.
For diagnostic imaging, there are 7 different APCs (see image above).
For a complete list of APCs and corresponding CPT codes, please:
- Go to: https://www.cms.gov/medicaremedicare-fee-service-paymenthospitaloutpatientpps/cms-1753-fc
- Select “2022 NFRM OPPS Addenda”
- Choose “Accept”
- Select “Addendum B”