Q/A: Payment for partial hospitalization services
APCs Insider, July 8, 2011
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Q: Is CMS proposing any changes to the APCs for partial hospitalization programs (PHPs)?
A: The 2012 OPPS proposed rule, released July 1, would continue CMS’ methodology for creating separate APCs for partial hospitalization when provided in a hospital setting or a freestanding community mental health center (CMHC).
CMS would update the four existing CMHC PHP APC payment rates—two for freestanding CMHC PHPs, and two for hospital-based PHPs. Pursuant to its proposal, CMS would pay:
- $97.78 for APC 0172 (level 1 partial hospitalization for CMHC)
- $113.62 for APC 0173 (level II partial hospitalization CMHC)
- $162.34 for APC 0175 (level 1 partial hospitalization for hospital-based PHPs)
- $189.87 for APC 0176 (level II Partial Hospitalization for hospital-based PHPs)
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