Medical, Dental & Pharmacy
- Medical
- Ambulatory Surgical Services
- Children's Services
- Chiropractic
- Clinic Services
- Community First Services and Supports (CFSS)
- Early Intensive Development and Behavioral Intervention (EIDBI)
- Equipment and Supplies
- HCBS
- Hearing Services
- Home Care Services
- Hospice Services
- Hospital Services
- Housing Stabilization Services
- Immunizations and Vaccinations
- Laboratory/Pathology, Radiology, and Diagnostic Services
- Language Interpreter Services
- Long-Term Care
- Medication Reconciliation
- Mental Health Services
- Optical Services
- Personal Care Assistance (PCA) Services
- Physician and Professional Services
- Recuperative Care
- Rehabilitation Services
- Renal Dialysis
- Restricted Recipient Program
- School-Based Community Services
- Substance Use Disorder
- Telehealth Services
- Transportation
- Tribal and Federal Indian Health Services
- Dental
- Pharmacy
Hospital Services
Hospital services include inpatient and outpatient services provided in a facility qualified to participate in Medicare. Hospital services must be medically necessary and provided by or under the supervision of a physician, dentist, or other provider having medical staff privileges in the hospital.
Non-Ambulatory Payment Classification (APC) Facilities
The following facilities are not subject to the APC payment methodology:
- Community Mental Health Centers (CMHCs)
- Hospice
- Comprehensive Outpatient Rehabilitation Facilities (CORFs)
- CAHs
- Federally Qualified Health Centers (FQHCs)
- Rural Health Clinics (RHCs)
- Non-surgical Indian Health Service (IHS)
- Freestanding Ambulatory Surgery Centers (ASCs)
Urgent care facilities must follow Medicare guidelines for the facility charge.
PW_11-18_492
Updated_11/09/2018
