Coding and payment for drug administration under the hospital outpatient prospective payment system (OPPS)

Why This Topic Matters

Hospitals that bill under OPPS need to understand the current CMS manual guidance so their drug administration claims and associated drug reporting align with federal payment policy and applicable coding references.

Article Sections

1. Separately payable drugs

   Covers the category of drugs that are reported alongside administration services and addressed separately in hospital outpatient billing guidance.

2. Packaged drugs

   Discusses the group of drugs that may be included in broader payment structures and the associated reporting context.

3. Pass-through drugs

   Summarizes policy discussion for temporary additional payment considerations under the Social Security Act.

4. Non-pass-through drugs

   Describes drugs and related products that are not treated as pass-through items and how they are addressed within APC-based payment structures.

5. Coding and payment for drug administration

   Reviews the CMS and AHA coding references cited for hospital drug administration reporting and the broader instructional update.