Ambulatory Payment Classifications (APCs) are used in which payment system to categorize outpatient services?

• A. OPPS
• B. IPPS
• C. SNF PPS
• D. Ambulatory Payment Classifications (APCs)

Answer: (A)

Ambulatory Payment Classifications are part of the hospital outpatient prospective payment system. In OPPS, outpatient services provided in hospital outpatient departments are grouped into APCs that cover services with similar clinical characteristics and expected costs. Each APC has a single payment rate that includes the facility and ancillary costs, standardizing how outpatient care is paid and promoting consistency across hospitals.

The other systems operate differently: the inpatient prospective payment system uses diagnosis-related groups to classify inpatient stays, and the skilled nursing facility PPS uses resource utilization groups. The term APCs specifically refers to the outpatient classification scheme within OPPS.