Health Information Management

Opinions on proposed payment changes to type B EDs vary

APCs Insider, October 31, 2008

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CMS has proposed the creation of four new APCs for Type B ED visits in the 2009 OPPS proposed rule, based on claims data from providers.

Recent CMS data indicate that Type B visits are more expensive than clinic visits but cost less than Type A ED visits. The agency classifies most EDs as Type A, offering services 24/7. By contrast, Type B EDs offer emergency services but are open fewer hours.

CMS now pays for emergency visits provided in the Type B ED at the same rate as a non-emergency visit to an outpatient department. Under the proposed rule, CMS would reimburse the most intensive emergency visits with an APC shared by both types, on the premise that costs for these services are similar in Type A and Type B EDs.

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