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Outpatient/Ambulatory Health Services

Outpatient/Ambulatory Health Services

HRSA Service Definition

Outpatient/Ambulatory Health Services are diagnostic and therapeutic services provided directly to a client by a licensed healthcare provider in an outpatient medical setting. Outpatient medical settings include clinics, medical offices, and mobile vans where clients do not stay overnight. Emergency room or urgent care services are not considered outpatient settings.

Allowable activities include:

  • Medical history taking
  • Physical examination
  • Diagnostic testing, including laboratory testing
  • Treatment and management of physical and behavioral health conditions
  • Behavioral risk assessment, subsequent counseling, and referral
  • Preventive care and screening
  • Pediatric developmental assessment
  • Prescription, and management of medication therapy
  • Treatment adherence
  • Education and counseling on health and prevention issues
  • Referral to and provision of specialty care related to HIV diagnosis

Program Guidance:

Treatment Adherence services provided during an Outpatient/Ambulatory Health Service visit should be reported under the Outpatient/Ambulatory Health Services category whereas Treatment Adherence Services provided during a Medical Case Management visit should be reported in the Medical Case Management service category.

As part of Outpatient and Ambulatory Medical Care, provision of laboratory tests integral to the treatment of HIV infection and related complications.

Number of Clients Served, Units Provided, Expenditures,* Cost per Client and 3 Year averaged Cost per Client (based on actual expenditures)

Year 2015 2016 2017 2018 2019
Medical Care Clients 11,201 11,011 11,176 11,056 11,617
Medical Care Units (Dr. visit) 39,965 38,850 35,662 36,606 35,511
Medical Care Dollars $7,476,559 $7,227,633 $7,104,406 $7,362,705 $7,328,009
Allocated Dollars $7,101,939 $7,152,427 $7,162,288 $7,055,207 $6,952,646
Over/ Underspending $374,620 over $75,206 over $57,882 under $307,498 over $375,363 over

*Includes Minority AIDS Initiative (MAI) funding

Funding by Part, and info on any other payers

Total Part A Funds (Formula + Supp.) MAI Total Part B Funds (Formula + Supp. NJ) Total Part B Funds (Formula + Supp. PA) Total Part C EIS Funds (State & Local) Total Part D Funds (State & Local) Total Part F Funds
Last Year Allocation $6,587,785 $364,861 $471,071 $836,135 $4,726,308
Current Allocation $6,545,974 $369,478 $812,384 $4,933,668

Consumer survey info 2017 n=392

n Used in the last 12 months Needed but did not get (last 12 months)
Ambulatory Health Services 242 93.8% 6.2%

Unmet need

For the purposes of this document, need is based on the response of a consumer when asked if there was a service they needed. MMP interviews patients in care and asks consumers if they need a service and if they receive it. Client services unit data identifies needs at the time of initial intake.

2016 MMP Percent with a Need 2018 Client Services Unit Need at Intake
Ambulatory Health Services 4.2% 32.8%

Recipient Service Considerations

None.