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A quarterly implementation process will be necessary to create new HCPCS codes and implement the necessary claims processing changes to effectuate the calculated payment rates as well as the required payment limitations

All services and items within an APC group are comparable clinically and with respect to resource use, as required by section 1833(t)(2)(B) of the Act

For example, vitamin B12 injections may lead to skin changes, such as acne and dermatitis (rash)

Except for newly opened hospitals, we apply the cap for a fiscal year using the final wage index applicable to the hospital on the last day of the prior fiscal year

This gradual escalation mitigates nausea and gastrointestinal adverse effects while allowing receptor-level adaptation