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HIM methodology question

  1. #1
    Post HIM methodology question
    Medical Coding Books
    APGs are a methodology used by medicaid and not medicare! Is this True?

    If true: Can I say then APCs are used by medicare and not medicaid?

  2. #2
    Thumbs up HIM Methodology question
    It is my understanding the APG's (Ambulatory Payment Group) was the methodology developed for and used by Medicaid (and private BCBS plans) to pay for outpatient procedures performed in hospitals or freestanding facilities. This method was never adopted by Medicare. However, the BBA of 1997 mandated that Medicare implement some method of outpatient payment and in 2000, Medicare started reimbursing for these services using the APC (Ambulatory Payment Classification).
    Felicia A. Thomas, CPC
    Atlanta, GA

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