Ambulatory Payment Classification (APC)
Iowa Medicaid uses the Ambulatory Payment Classifications (APC) methodology to reimburse for prospective payment system (PPS) outpatient hospital services. The following documents outline the Iowa Medicaid coverage of services, APC groups, fee schedule payment rates, maximum units, discounting and packaging formulas, and the Outpatient Code Editor (OCE) edits used for claims processing.
- Medicaid Addendum B (CY 23-October)
- Medicaid Addendum B (CY 23-July)
- Medicaid OCE Edits (April 2022)
- Medicaid Addendum B (CY 23-April)
- Medicaid Addendum B (CY 23-January)
- Medicaid Addendum B (CY 22-July)
- Medicaid Addendum B (CY 22-April)
- Medicaid Addendum B (CY 22-January)
- Medicaid Addendum B (CY 21-October)
- Medicaid Addendum B (CY 21-July)
- Medicaid Addendum B (CY 21-April)
- Medicaid Addendum B (CY 21-January)
- Medicaid Addendum B (CY 20-October)
- Medicaid Addendum B (CY 20-July)
- Medicaid Addendum B (CY 20-April)
- Discounting Formulas
- Iowa Medicaid Status Indicators
- Packaging Flag Descriptions
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For telephone accessibility assistance if you are deaf, hard-of-hearing, deaf-blind, or have difficulty speaking, call Relay Iowa TTY at 1-800-735-2942.
Llame al 1-800-735-2942, a Relay Iowa TTY (teléfono de texto para personas con problemas de audición, del habla y ceguera) si necesita asistencia telefónicamente.
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