tci ED Coding & Reimbursement Alert - 2016 Issue 1

Payment Thresholds in Place for Pass Through Drugs

For 2016, a hospital will be eligible for an outlier payment if its cost of furnishing a service exceeds 1.75 times the APC payment amount and exceeds the APC payment amount plus $3,250.  The payment thresholds this year (2015) are 1.75 times the APC payment amount and a fixed dollar threshold of $2,775. If the cost of a service exceeds both the multiplier threshold and the fixed-dollar threshold, the outlier payment is calculated as 50 percent of the amount by which the cost of furnishing the service exceeds 1.75 times the APC payment...

To read the full article, sign in and subscribe to tci ED Coding & Reimbursement Alert.


You have ED coding questions, and we deliver money-in-the-bank answers to help you defeat your claim issues and secure optimal reimbursement.

Stay in the know and avoid federal reproach with your subscription to TCI’s ED Coding and Reimbursement Alert.

  • Current newsletters added each month
  • Fully searchable archives - over 2100 articles
  • ALL years/issues back to 1998 organized by year and issue
  • Codes mentioned in articles are linked to Code Information pages
  • Code Information pages link back to related articles

This feature is currently unavailable for online purchase. For more information, please call 801-770-4203 or Contact Us.

demo
request yours today
 subscribe
start today
 newsletter
free subscription

Thank you for choosing Find-A-Code, please Sign In to remove ads.