CMS Pub. 100-04, ch. 4, § 60.5

Payments

(Rev. 3941; Issued: 12-22-17; Effective: 01- 01-18; Implementation: 01-02-18)

Under OPPS, services eligible for payment through New Technology APCs are those

codes that are assigned to the series of New Technology APCs published in Addendum A

of the latest OPPS update. As of January 1, 2018, the range of New Technology APCs

include

• APCs 1491 through 1500

• APCs 1502 through 1537

• APCs 1539 through 1585

• APCs 1589 through 1599, and

• APCs 1901 through 1908

OPPS considers any HCPCS code assigned to the above APCs to be a “new technology

procedure or service.”

Application procedures for consideration as a New Technology procedure or service may

be found on the CMS Web site, currently at https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/HospitalOutpatientPPS/passthrough_payment.html. Under the

“Downloads” section, refer to the document titled “For a New Technology Ambulatory

Payment Classification (APC) Designation under the Hospital Outpatient Prospective

Payment System (OPPS)” for information on the requirements for submitting an

application.

The list of HCPCS codes and payment rates assigned to New Technology APCs can be

found in Addendum B of the latest OPPS update regulation each year at

https://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/HospitalOutpatientPPS/Addendum-A-and-Addendum-B-Updates.html. Please

note that this link may change depending on CMS Web design requirements