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Credentialing Glossary

APC (Ambulatory Payment Classification)

medical-coding

Definition

Outpatient hospital payment classification under the OPPS (Outpatient Prospective Payment System). 931 active APCs in 2026. Each HCPCS code maps to a status indicator that determines whether it is paid via APC, packaged into another payment, or paid separately. Hospital outpatient billing requires both the procedure code and the correct revenue code on the UB-04.

Every month un-credentialed is revenue you never bill

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