Comprehensive APCs

10.2.3 - Comprehensive APCs (Rev. 12421; Issued: 12-21-23; Effective: 01-01-24; Implementation: 01-02-24) The following services are excluded from comprehensive APC packaging: • ambulance services • brachytherapy sources (status indicator U) • diagnostic and mammography screenings • physical therapy, speech-language pathology and occupational therapy services reported on a separate facility claim for recurring services • pass-through drugs, biologicals, and devices (status indicators G or H) • preventive services defined in 42 CFR 410.2 • self-administered drugs (SADs) - drugs that are usually self-administered and do not function as supplies in the provision of the comprehensive service • services assigned to OPPS status indicator F (including certain CRNA services, Hepatitis B vaccines and corneal tissue acquisition) • services assigned to OPPS status indicator L (including influenza, pneumococcal pneumonia, and COVID-19 vaccines) • certain Part B inpatient services – Ancillary Part B inpatient services payable under Part B when the primary J1 service for the claim is not a payable Medicare Part B inpatient service (for example, exhausted Medicare Part A benefits, beneficiaries with Part B only) • services assigned to a New Technology APC • Any drug or biological described by HCPCS code C9399 (Unclassified drugs or biologicals)