Respiratory Question for the Week of January 23, 2017

Question:

Did CMS make any changes to the APCs for endoscopies in the 2017 OPPS?

Answer:

In the 2016 outpatient prospective payment system (OPPS) final rule, the Centers for Medicare & Medicaid Services (CMS) issued five new APCs for airway endoscopies, which continue in 2017. APCs 5151–5155 cover the five levels, which range in price from $146.14 for level 1 to $4,361.11 for level 5. The price of the specific codes can be found in the OPPS Addendum B at https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/HospitalOutpatientPPS/Addendum-A-and-Addendum-B-Updates.html.

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