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Clinic Services In the Hospital Outpatient Setting ...

Manual: Reimbursement Policy Policy Title: Clinic Services In the Hospital Outpatient Setting Section: Evaluation & Management Services Subsection: None Date of Origin: 8/9/2018 Policy Number: RPM061 Last Updated: 12/14/2021 Last Reviewed: 12/14/2021 Scope This policy applies to all Commercial medical plans for claims with dates of service january 1, 2019 and following. This policy also applies to Summit Health plans for these lines of business. This policy does not apply to Medicare Advantage plans or Medicaid plans. This policy does not apply to Hospitals paid on an OPPS-based fee schedule, or Critical Access Hospitals (CAH).

(Effective January 1, 2016) 22 . On Campus-Outpatient Hospital ; A portion of a hospital’s main campus which provides diagnostic, therapeutic (both surgical and nonsurgical), and rehabilitation services to sick or injured persons who do not require hospitalization or institutionalization. (Description change effective January 1, 2016)

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