Return to CAP Home
Printable Version

  Feature Story

title
 

cap today

Outpatient PPS at a glance

Back to Feature Story

July 2000
Sidebar

  • Professional components of pathology physician services remain separately billable to the local Part B Medicare carrier (no change to current status).
  • Independent laboratories that provide the technical component of pathology physician services to registered hospital outpatients will have to bill the hospital for the TCs beginning Aug. 1. The hospital will be paid for the TCs by the Part A intermediary, using the PPS ambulatory payment classifications system.
  • Independent laboratories that provide clinical diagnostic laboratory services to registered hospital outpatients will continue to have to bill the hospital for the services. But the tests remain payable to the hospital under the Medicare clinical laboratory fee schedule and are not bundled into the PPS APCs.
  • A registered hospital outpatient is a person who has not been admitted as an inpatient but who is registered on the hospital records as an outpatient and receives services (rather than supplies alone) directly from the hospital.