CY 2022 Comprehensive APC Payment Policy Exclusions
Ambulance services
Brachytherapy
Diagnostic and mammography screenings
"Physical therapy, speech-language pathology and occupational therapy services reported on a separate facility claim for recurring services"
"Pass-through drugs, biologicals, and devices"
Preventive services defined in 42 CFR 410.2
Self-administered drugs (SADs) - Drugs that are usually self-administered and do not function as supplies in the provision of the comprehensive service
"Services assigned to OPPS status indicator “F” (certain CRNA services, Hepatitis B vaccines and corneal tissue acquisition)"
Services assigned to OPPS status indicator “L” (influenza and pneumococcal pneumonia vaccines)
"Certain Part B inpatient services – Ancillary Part B inpatient services payable under Part B when the primary “J1” service for the claim is not a payable Medicare Part B inpatient service (for example, exhausted Medicare Part A benefits, beneficiaries with Part B only)"
Services assigned to a New Technology APC 
FDA-authorized or approved drugs and biologicals (including blood products) that are authorized or approved to treat or prevent COVID-19
"For the remainder of the PHE for COVID-19, new COVID-19 treatments that meet the following criteria: 1) The treatment must be a drug or biological product (which could include a blood product) authorized to treat COVID-19, as indicated in section “I. Criteria for Issuance of Authorization” of the letter of authorization for the drug or biological product, or the drug or biological product must be approved by the FDA for treating COVID-19 2) The emergency use authorization (EUA) for the drug or biological product (which could include a blood product) must authorize the use of the product in the outpatient setting or not limit its use to the inpatient setting, or the product must be approved by the FDA to treat COVID-19 disease and not limit its use to the inpatient setting. "
