Wiki ASC Grouper List Question

[Anduiza05]

Hello,

Does anyone know where I can access the 2013 ASC grouper list for Houston, TX? I work for a company that is trying to analyze the payment structure for these codes and they need to know what are listed in each grouper 1-9.

Any help or reference tools would be appreciated.

Thanks

 

[nsteinhauser]

No one uses the 'groupers' anymore that I know of. Do you have a payer that says they are basing their reimbursement on 'groupers'? A number of payers we deal with are basing allowed amounts for the facility on APCs (from the final OPPS payment schedule.)

 

[Anduiza05]

Well this new to my company (payer) we have a client that wants fees analyzed by the grouper numbers from Medicare. I could not find this information so what you are saying makes more sense. We might need to look at the ASC's fee not the grouper number?

 

[nsteinhauser]

Are you the payer? And one of your clients - (a provider?) - wants their fee schedule analyzed? Maybe they just want you to explain to them how you came up with the allowed amounts on their fee schedule?