2017 APC Consolidation Analysis Tool

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By AHRA Staff

AHRA has put together a tool that allows members to analyze the effect of the 2017 APC category consolidation on their department’s revenue. As a refresher, each CPT code is grouped into one of the various Ambulatory Payment Classifications (APCs) for purposes of payment under the Outpatient Prospective Payment System.

The number of imaging APC Categories was reduced from 17 in CY 2016 to just 7 in CY 2017. As a result of this consolidation, a number of imaging services will be paid at significantly different rates in 2017 than they were in 2016. Some services saw a significant increase in payment while other services saw a significant decline in payment. The overall effect of these changes on your imaging center will depend on the mix of services and frequency thereof that your imaging department provides.

To help you analyze how your revenue will be affected by these changes, input the expected frequency of each CPT code for the upcoming year into column H. The spreadsheet will then automatically calculate your new 2017 payment and compare it to your 2016 payment. The spreadsheet does not take into account any geographic adjusters you may receive.

Click here to download the spreadsheet.

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