"Payment for Nonexcepted Items and Services in Nonexcepted Off-Campus Provider Based Departments of a Hospital, by OPPS Status Indicator"			
OPPS Status Indicator	Item/Service Category	OPPS Payment Prior to Section 603 Implementation	MPFS Payment Adopted for CY 2018
A	Ambulance Services	Paid according to Ambulance fee schedule	No change relative to current payment
	Separately payable clinical diagnostic laboratory services	Paid according to CLFS fee schedule	
	Separately payable non- implantable prosthetics and orthotics	Paid according to DMEPOS fee schedule	
	"Physical, Occupational, and Speech Therapy"	Paid according to MPFS Facility Rate	
B	Codes not recognized by OPPS when submitted on outpatient hospital bill type	Not Applicable	
C	Inpatient Procedures	Not Applicable	
D	Discontinued Codes	Not Applicable	
E1	Not covered by any Medicare outpatient benefit category	Not Applicable	
E2	Medicare covered item; no pricing available	Not Applicable	
F	Corneal tissue acquisition	Paid at reasonable cost	No change relative to current payment
	Certain CRNA services		
	Hepatitis B Vaccines		
G	Pass-through drugs and biologicals	ASP+6%	ASP+6%
H	Pass-through device categories	"Amount by which the hospitals charges, adjusted to cost, exceeds the OPPS payment rate associated with the device"	No change relative to current payment
J1	Hospital Part B services paid through a comprehensive APC	Claim-level packaged payment	Paid 40 % of C-APC rate
J2	Hospital Part B services that may be paid through a Comprehensive APC (Observation)	Comprehensive APC Payment	Paid 40% of C-APC rate
K	"Nonpass-through drugs, biologicals, therapeutic radiopharmaceuticals"	ASP+6%	ASP+6%
L	Influenza Vaccine	Paid at reasonable cost	Paid at reasonable cost
	Pneumocccal Pneumonia Vaccine		
M	Items and Services not billable to the MAC	Not Applicable	
OPPS Status Indicator	Item/Service Category	OPPS Payment Prior to Section 603 Implementation	MPFS Payment Adopted in this Interim Final Rule with Comment Period
N	Items and Services Packaged into APC rates	Payment packaged with procedure	No change relative to current payment
P	Partial hospitalization	Separate APC payment	CMHC Rate
Q1	STV-packaged codes	"Packaged APC payment if billed on same claim with S, T, or V
procedure"	"Paid at 40% of APC rate if billed without S, T, or V procedure; otherwise packaged"
Q2	T-packaged codes	Packaged APC payment if billed on same claim with T procedure	Paid at 40% of APC rate if billed without T procedure; otherwise packaged
Q3	Codes that may be paid through a composite APC	Composite payment when criteria met; otherwise separate APC payment or packaged payment	Paid at 40% of APC rate if composite criteria met; otherwise packaged
Q4	Conditionally packaged laboratory tests	"Conditionally packaged APC payment when billed on same claim with HCPCS codes assigned SI J1, J2, S, T, V, Q1, Q2, or
Q3; otherwise paid under clinical laboratory fee schedule"	Paid at CLFS rate when billed without primary service; otherwise packaged
R	Blood and blood products	Charges reduced to costs	No change relative to current payment
S	"Procedure or Service, Not Discounted when multiple"	Separate APC payment	Paid at 40% of APC rate
T	"Procedure or Service, Multiple Procedure Reduction Applies"	Separate APC payment	Paid at 40% of APC rate Existing MPFS Multiple Procedure Payment Reduction Policies Apply
U	Brachytherapy sources	Charges reduced to costs	No change relative to current payment
V	Clinic Visit	Separate APC payment	Paid at 40% of APC Rate
Y	Non-implantable Durable Medical Equipment	Paid according to DMEPOS fee schedule	No change relative to current payment
