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However, the underlying cause of the deficiency must also be addressed in order to prevent relapse and further complications
When the aggregate payment for specified mental health services provided by one hospital to a single beneficiary on a single date of service, based on the payment rates associated with the APCs for the individual services, exceeds the maximum per diem payment rate for four partial hospitalization services provided in a day by a hospital (the payment amount for APC 5864), those specified mental health services would be paid through composite APC 8010 for CY 2026
PCCA is deeply committed to adhering to the strictest standards of quality and regulatory compliance
of the CY 2026 OPPS/ASC proposed rule that if a payer-specific negotiated charge is based on a percentage or algorithm, the hospital's MRF would have to describe the percentage or algorithm that determines the dollar amount for the item or service and the hospital would have to calculate and encode the median allowed amount in dollars for that item or service
US$ 21.03
US$ 27.60
US$ 29.87
US$ 20.80
US$ 29.82
US$ 25.59
