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Discuss the two-times rule applied to APC groups. What is an APC?

Discuss the two-times rule applied to APC groups. What is an APC?

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Answer #1

APC stands for Ambulatory Payment Classification (APC) which is a government system for reimbursing acute care facilities for outpatient services under Medicare Program.

Two- times rule: Based on the CM's guideline related to APC two-times rule: the median cost of the most expensive procedure or service in the Ambulatory Payment Classification (APC) cannot be more than two times greater than the median cost of the least expensive procedure or ser-vice in the same group.

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