Health Information Management

Pay-per-view: Proposed IPPS-based payment cap raises concerns

APCs Insider, October 7, 2011

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CMS' plan to cap payment for cardiac resynchronization therapy (CRT) based on Medicare severity diagnosis-related group (MS-DRG) 227 payment drew plenty of discussion at the August 12 APC Advisory Panel on Ambulatory Payment Classification Groups meeting.

As part of the 2012 OPPS proposed rule, CMS announced plans to create a new composite APC for CRT defibrillator (CRT-D) and CRT pacemaker (CRT-P) procedures. CMS proposes capping payment for those services at the lesser of the newly established APC median cost or the inpatient standardized payment for MS-DRG 227.

Continue reading “Proposed IPPS-based payment cap raises concerns ” HCPro’s website. Subscribers to Briefings on APCs have free access to this article in the October issue.



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