APCs have disturbing impact on emergency observation services.

There is a disturbing trend of ED observation units being put on hold or closing due to no separate payment under ambulatory payment classifications (APCs), but you can receive reimbursement. Many procedures that an ED patient undergoes while under observation can be coded under APCs, including a repeat EKG, exercise stress testing, and cardiac monitoring. Closing observation units could present liability risks depending on how physician thresholds for admission change. Commercial payers still might pay for observation services, and ED physicians still are reimbursed for the professional portion of observation services.