What is APC in Healthcare?

In healthcare, APC stands for either advanced practice clinician or ambulatory payment classification.

What is an Advanced Practice Clinician (APC)?

Advanced practice clinicians are clinicians who are not doctors, but provide a role that is very similar to a doctor. Advanced practice clinicians typically refers to advanced practice registered nurses (APRNs) and to physician assistants (PAs).

An APC is a healthcare provider who has had advanced training at the graduate level. In order to provide healthcare for patients and function as a provider, they must pass a national board examination for the state in which they will be providing care. APCs are not physicians, but normally practice under the supervision of a physician.

In some health systems and practices, the abbreviation APP (advanced practice provider) is used in place of APC. The term “advanced practice clinician” is very broad, and most APCs are referred to by the specific type of APC that they practice as.

APCs may also be called mid-level providers, as they have less education and independence to practice than physicians, but more than registered nurses or other members of the healthcare team. The term mid-level provider, however, is considered by some to be offensive as it can be seen to imply that APCs are inferior to physicians, while in reality they are able to practice with a similar level of skill and knowledge.

 Hospitals or doctors offices use APCs to enable a doctor to provide care to a greater number of patients. The care an APC provides normally is reviewed by a physician, but does not require much of the physician’s time. This enables the physician to focus on more complex cases while providing care to more patients than they could working entirely by themselves.

Types of Advanced Practice Clinicians

While there are only two types of clinical doctors, doctors of medicine (MDs) and doctors of osteopathic medicine (DOs), there are several types of APCs. MDs and DOs function almost identically in the medical setting, but the many different types of APCs can work in very different roles.

Physician Assistants (PAs)

Physician Assistants (PAs) work under a supervising physician, but perform exams, order tests, diagnose diseases, and prescribe medications just like a doctor would. In many ways a PA functions just like a doctor, but will often defer to the doctor if seeing complex cases. PAs also may not be able to perform some of the complex tasks that a doctor can.

Advanced Practice Registered Nurses (APRNs)

Advanced Practice Registered Nurses (APRNs) are nurses who have completed a masters- or doctoral-level nursing education. APRNs can fill a variety of different roles depending on the type of advanced nursing education and training they have completed. The main different types of APRNs include:

  • Certified Nurse Practitioners (NPs) – NPs function very similarly to PAs, but can practice independently without the supervision of a doctor in some states. NPs can also specialize in certain areas of practice, but typically provide direct patient care.
  • Clinical Nurse Specialists (CNSs) – CNSs play a similar role to NPs, but instead of being the provider who is primarily responsible for the patient’s care, they will act as expert consultants. CNSs are specialized in a particular area of medical knowledge, and serve as experts who provide care specifically in their area of expertise.
  • Certified Nurse-Midwife (CNMs) – CNMs are providers who are specifically trained in women’s health and midwifery. These clinicians help with the entire birthing and family planning process and have unique expertise and training in this area.
  • Certified Registered Nurse Anesthetists (CRNAs) – CRNAs are advanced practice nurses who specialize in managing pain and providing anesthesia during surgery. This is one of the most complex and specialized types of advanced practice that nurses participate in. CRNAs normally work under the direction of an anesthesiologist.

Benefits of Advanced Practice Clinicians

When a hospital or clinic uses APCs, it allows the providers more time to address the concerns and needs of their patients, provide education to them, and more comprehensively address their care. Using APCs at a healthcare facility lessens the overall workload for other providers, enabling everyone providing care to have more time with their patients. This, in turn, leads to better care and more personalized attention for each patient.

Having multiple providers working under one doctor can also improve the workflow and availability at a clinic. This can enable patients to get appointments more quickly and make healthcare more readily available to them. This improved workflow can also help reduce physician burnout from patient overload, helping clinics to function better as a whole. 

What is an Ambulatory Payment Classification (APC)?

While the abbreviation APC in healthcare typically refers to advanced practice providers, it can also refer to ambulatory payment classification. 

Ambulatory payment classification is a system for billing the federal government for outpatient services provided to Medicare and Medicaid patients.

APC payments are made only to hospitals and require certain criteria to be met in order for the hospital to be eligible for the payment. APC payments can cover billable expenses, such as diagnostic testing, surgery, emergency care, and more.

You can read more about ambulatory payment classifications here.

Leave a Comment