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ED Coding and Reimbursement Alert

Payment Thresholds in Place for Pass Through Drugs

Published on Wed Dec 23, 2015

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 [...]
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