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When APGs are implemented in facilities licensed under the Mental Hygiene Law, free standing mental hygiene providers (not hospital based providers) will have an APG phase-in period that is distinct from the phase-in schedule for D&TC clinic services listed above. The percentage will increase to 50% on Decemto 75% on and to 100% on Jan 1, 2012. The percentage will increase to 50% on Decemto 75% on and to 100% on Jan 1, 2012.įree-standing Ambulatory Surgery SeptemStarting on September 1, 2009, 25% of payment will be based on APGs. Hospital-Based Ambulatory Surgery Decem100% of payment will be based on APGs starting Dec 1, 2008.įree-standing Diagnostic and Treatment Center SeptemStarting on September 1, 2009, 25% of payment will be based on APGs. Hospital Emergency Room Janu100% of payment will be based on APGs starting Jan 1, 2009.

Hospital Outpatient Department DecemStarting Dec 1, 2008, 25% of payment will be based on APGs. The APG portion of the blend increases on December 1, 2009, January 1, 2011,and Januaccording to the following schedule: The existing payment used for blending purposes is based on a provider’s average per visit reimbursement for services moving to APGs for calendar year 2007.

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In the initial phase of blending, reimbursement for each individual visit is based on 25% of the full amount that the APG methodology would calculate for the visit (based on coded procedures and diagnoses) and 75% of a provider-specific existing payment for the blend amount. However, APG reimbursement for hospital outpatient departments, diagnostic and treatment centers and free-standing ambulatory surgery centers is phased-in as required by law.

** payment for long term care, home care, personal care.īoth hospital-based ambulatory surgery and emergency department services received 100% APG payment with the implementation of the APG reimbursement methodology. ** payment to Federally Qualified Health Centers (FQHCs), except when the FQHC has voluntarily agreed to participate in the APG reimbursement system, or ** payment for physicians’ services in hospital settings billed using the Physician Fee Schedule ** payment for Ordered Ambulatory services

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** capitated payments made on behalf of Medicaid managed care or Family Health Plus enrollees APGs are not currently applicable to services certified under the Mental Hygiene Law) ** services provided outside of a facility’s licensure under Article 28 of the Public Health Law (e.g. The APG payment methodology is not applicable to: The APG payment methodology is applicable to outpatient, ambulatory surgery and emergency department services provided by general hospitals and to ambulatory care services provided by diagnostic and treatment centers and free-standing ambulatory surgery centers. The purpose of this document is to provide Medicaid policy and billing guidance to Article 28 providers billing under the Ambulatory Patient Groups Payment methodology to the extent this methodology is applicable to hospital-based outpatient, ambulatory surgery, and emergency departments, and to free-standing diagnostic and treatment centers and free-standing ambulatory surgery centers. In case of any further query you can also visit Contact Us section of the website.BACKGROUND AND INTRODUCTION TO AMBULATORY PATIENT GROUPS (APGS) You can fine Phone/Support number given below. In case you want to redeem redeem rewards points visit Offers page. In My accounts section you can see your pending bills and make the payment by Online Banking facility.

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In case you have forgotten your password/user id you can press on Forgot password button. To login in one should visit the bill payment website and enter his/her username/password in the right section of the page and press login.

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