Hospital Type or Service Location | Does the Ambulatory Payment Classification System apply? | Do percent of allowed charges (POAC) payment methods apply? | Do the department's Medical Aid Rules and Fee Schedules apply to hospital outpatient radiology, laboratory, pathology, occupational therapy, and physical therapy services? |
Children's hospitals | No | Yes, paid 100% of allowed charges | Yes |
Chronic Pain Management Program | No | Exempt, paid per department agreement | Exempt, paid per department agreement |
Health Maintenance Organizations | Yes, paid statewide average per APC rate | Yes, applies to certain hospital outpatient services excluded from OPPS except radiology, laboratory, pathology, occupational therapy, and physical therapy | Yes |
Military | No | Yes, paid 100% of allowed charges | No, paid 100% of allowed charges |
Veterans Administration | No | Yes, paid 100% of allowed charges | No, paid 100% of allowed charges |
State psychiatric facility | No | Yes, paid 100% of allowed charges | Yes |
Other psychiatric hospitals | No | Yes, applies to hospital outpatient services except radiology, laboratory, pathology, occupational therapy, and physical therapy | Yes |
Rehabilitation hospitals | No | Yes, applies to hospital outpatient services except radiology, laboratory, pathology, occupational therapy, and physical therapy | Yes |
Cancer hospitals | No | Yes, applies to hospital outpatient services except radiology, laboratory, pathology, occupational therapy, and physical therapy | Yes |
Critical access hospitals | No | Yes, applies to hospital outpatient services except radiology, laboratory, pathology, occupational therapy, and physical therapy | Yes |
All other Washington hospitals | Yes | Yes, applies to certain hospital outpatient services excluded from OPPS except radiology, laboratory, pathology, occupational therapy, and physical therapy | Yes |