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Medicare program

A federal health insurance program for people 65 or older, certain younger people with disabilities, and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant).

Algorithm-based healthcare service

A healthcare service delivered through a medical device, approved by the FDA, that uses artificial intelligence, machine learning, or similar software to provide clinical information or conclusions for doctors to use in patient care, such as for screening, diagnosis, or treatment.

Ambulatory Payment Classification (APC)

A system used by Medicare to classify and pay for services provided in hospital outpatient departments and certain other settings. Services that are clinically similar and use similar resources are grouped into APCs for payment.

New Technology Ambulatory Payment Classification

A special category within Medicare's APC system designed to provide payment for new medical technologies or services that do not yet have established payment rates due to a lack of sufficient claims data or similar services.

Hospital Outpatient Prospective Payment System (OPPS)

The method Medicare uses to pay for most services patients receive in a hospital outpatient department, where payments are determined in advance based on the services provided, typically through APCs.

Software as a service (SaaS)