Beginning May 15, 2023, PacificSource Health Plans will use the CMS/National Correct Coding Initiative (NCCI) designation for the consideration of C-code reimbursements.
- C-codes with a dollar amount assigned are eligible for reimbursement at the contracted benefit level.
- C-codes with no dollar amount assigned are not eligible for separate reimbursement, as they are considered “bundled” services.
For more information, visit the Addendum A and Addendum B Updates on the CMS.gov, Hospital Outpatient Prospective Payment System (OPPS) website.