Which classification system is used for outpatient hospital services under Medicare?

The classification system used for outpatient hospital services under Medicare is known as the Ambulatory Payment Classification (APC) system. This system was specifically designed to group outpatient services into categories that can be paid for under the Medicare Outpatient Prospective Payment System (OPPS). Each APC is assigned a payment rate, which is derived from the costs associated with the services included in that category.

APCs are utilized to ensure that outpatient services are reimbursed fairly and consistently based on the resources used to deliver those services. This helps to streamline the reimbursement process and provides providers with clear guidelines on billing and payment for outpatient care.

In contrast, the other systems mentioned have different purposes: Diagnosis-Related Groups (DRGs) are primarily associated with inpatient hospital stays; International Classification of Diseases (ICD) codes are used for the diagnosis and classification of diseases; and Healthcare Common Procedure Coding System (HCPCS) codes are implemented for billing medical services and procedures, but are not specific to outpatient hospital services under Medicare.