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Question:
In Addendum B of the hospital OPPS, I see several different SIs listed for drugs. What do these letters indicate?
Answer:
The four most commonly assigned payment status indicators (SIs) for drugs and biologicals are listed below along with a description of their meanings.
| SI | Item and Payment Status |
| G | Pass-through drugs and biologicals: Paid under OPPS; separate APC payment |
| K |
Nonpass-through drugs and nonimplantable biologicals, including therapeutic radiopharmaceuticals: Paid under OPPS; separate APC payment |
| L |
Influenza vaccine; pneumococcal pneumonia vaccine: Not paid under OPPS; paid at reasonable cost; not subject to deductible or coinsurance. |
| N |
Items and services packaged into APC rates: Paid under OPPS; payment is packaged into payment for other services, so there is no separate APC payment. |
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Fee schedules, relative value units, conversion factors and/or related components are not assigned by the AMA, are not part of CPT, and the AMA is not recommending their use. The AMA does not directly or indirectly practice medicine or dispense medical services. The AMA assumes no liability for data contained or not contained herein.
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