Health Information Management

Q/A: Nonsurgical extended duration therapeutic services

APCs Insider, November 19, 2010

Want to receive articles like this one in your inbox? Subscribe to APCs Insider!

Q: Did CMS finalize the list of nonsurgical extended duration therapeutic services in the 2011 OPPS final rule?

A: In the 2011 OPPS final rule, CMS selected 16 services to include in the new category of nonsurgical extended duration therapeutic services, including observation, intravenous infusion, subcutaneous infusion, and therapeutic, prophylactic, or diagnostic injections. You can view the list in Table 37 of the 2011 OPPS proposed rule.

When selecting the services for the new category, CMS stated the services must:

  • Be of extended duration, frequently extending beyond normal business hours
  • Largely consist of a significant monitoring component typically conducted by nursing or other auxiliary staff 
  • Be of sufficiently low risk, such that the service typically would not require direct supervision often during the service
  • Not be a surgical service that includes recovery time

CMS excluded all surgical services—including recovery time—from potential inclusion because, although monitoring of any patient in recovery is a component of surgery, it is not the focus or a substantial component of the service. In addition, CMS states it believes the surgeon should personally evaluate the patient’s medical status during the recovery period.

CMS plans to form a panel to review the supervision requirements for all outpatient services.



Want to receive articles like this one in your inbox? Subscribe to APCs Insider!

Most Popular