GP1

Grouping/Reimbursement - Visit

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2.8.1Mar2014

2.8.2Jun2015

2.9Nov2019

These fields are used in grouping and reimbursement for CMS APCs. Please refer to the "Outpatient Prospective Payment System Final Rule" ("OPPS Final Rule") issued by CMS.

The GP1 segment is specific to the US and may not be implemented in non-US systems.

RRequiredOOptionalCConditionalWWithdrawn|#Date/Time*Backward compat.+Filler

		C.Len						Element
1	-	-	CWE	R	1	0455	01599	GP1-1	Type of Bill Code
2	-	-	CWE	O	*	0456	01600	GP1-2	Revenue Code
3	-	-	CWE	O	1	0457	01601	GP1-3	Overall Claim Disposition Code
4	-	-	CWE	O	*	0458	01602	GP1-4	OCE Edits per Visit Code
5	-	-	CP	O	1	-	00387	GP1-5	Outlier Cost

Used In Message Structures