|
|
.
2025B Ambulatory Payment Classification: 5031
Title: Level 1 Type B ED Visits
| 2025B Relative Weight: | 0.9428 |
| 2025B Payment Rate: | $ 84.07 |
| 2025B National Unadjusted Copay: | $ 0.00 |
| 2025B Minimum Unadjusted Copay: | $ 16.82 |
Addendum D1 Information
Status Indicator: V
Item / Code / Service:
Clinic or Emergency Department Visit
OPPS Payment Status:
Paid under OPPS; Separate APC payment.
|
| 2021 Top 10 OPPS Facility Claims for APC 5031* |
| NPI | Organization | APC 5031 Submitted |
| 1992910152 |
BRIDGEPORT HOSPITAL-BRIDGEPORT-CT
|
XXX
|
| 1346251543 |
ST. LUKES EPISCOPAL-PRESBYTERIAN HOSPITAL-CHESTERFIELD-MO
|
XXX
|
| 1982658407 |
LEE MEMORIAL HEALTH SYSTEM-CAPE CORAL-FL
|
XXX
|
| 1487760906 |
CAPE MEMORIAL HOSPITAL INC-CAPE CORAL-FL
|
XXX
|
| 1023114634 |
HENRY FORD MACOMB HOSPITAL CORPORATION-MOUNT CLEMENS-MI
|
XXX
|
| 1558302570 |
LEE MEMORIAL HEALTH SYSTEM-CAPE CORAL-FL
|
XXX
|
| 1144397134 |
UCH-MHS-LOVELAND-CO
|
XXX
|
| 1700910189 |
DIGNITY COMMUNITY CARE-CHANDLER-AZ
|
XXX
|
| 1972503142 |
MARSHALL MEDICAL CENTER-PLACERVILLE-CA
|
XXX
|
| 1922043744 |
UNIVERSITY OF WISCONSIN HOSPITALS AND CLINICS AUTHORITY-MIDDLETON-WI
|
XXX
|
* Medicare Part A utilization data is derived from the 100% 2021 Outpatient (Fee-for-Service) Standard Analytical File.
Procedure Codes in this APC:
G0380 Lev 1 hosp type b ed visit
|
Sources: Updates of Addendum A and B are posted quarterly to the OPPS website. These addenda are a "snapshot" of HCPCS codes and their status indicators,
APC groups, and OPPS payment rates, that are in effect at the beginning of each quarter. The quarterly updates of Addendum A and Addendum B reflect
the OPPS Pricer changes that are part of the quarterly OPPS recurring update notification transmittals.
http://www.cms.gov/HospitalOutpatientPPS/AU/list.asp#TopOfPage
For more information on the Composite APC payment,
please see CMS Transmittal R2141CP.
|
|
