Health Information Management

Tip: CMS expands packaging in 2015

APCs Insider, January 16, 2015

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CMS finalized changes for conditional packaging of ancillary services in the 2015 OPPS final rule. CMS will eliminate status indicator X (ancillary services) and assigns services with this status indicator to other indicators, mainly Q1 (conditionally packaged), but also S (significant procedure, not discounted when multiple). Status indicator Q1 means CMS may or may not pay for the service separately, depending on what else is billed on the same date of service.
CMS also decided to package other services it considers to be ancillary if the geometric mean cost was less than or equal to $100, with some exceptions for preventive services, certain counseling/psychiatry services, and drug administration services. CMS is examining alternative payment policies for drug administration.
This tip is adapted from “CMS finalizes comprehensive APCs with complexity adjustments for 2015” in the January issue of Briefings on APCs.

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