ATTENTION FREESTANDING CHEMICAL DEPENDENCE OUTPATIENT CLINICS, CHEMICAL DEPENDENCE OUTPATIENT REHABILITATION AND OUTPATIENT YOUTH PROGRAMS

ATTENTION FREESTANDING CHEMICAL DEPENDENCE OUTPATIENT CLINICS, CHEMICAL DEPENDENCE OUTPATIENT REHABILITATION AND OUTPATIENT YOUTH PROGRAMS

Effective January 1, 2014 APG reimbursement methodology will be fully implemented in Freestanding Chemical Dependence Outpatient Clinics, Chemical Dependence Outpatient Rehabilitation and Outpatient Youth Programs.

This is a reminder that effective January 1, 2014 APG reimbursement will be fully implemented in Freestanding Chemical Dependence Outpatient clinics, Chemical Dependence Outpatient Rehabilitation programs, and Outpatient Youth programs. This is the conclusion of the multi-year phase-in from the blended threshold/legacy APG reimbursement methodology to full APG reimbursement. Effective January 1, 2014 reimbursement for services provided will be calculated using only the APG reimbursement methodology (e.g. APG base rate X service weight, minus any applicable service discounts).

Freestanding Chemical Dependence Outpatient clinics, Chemical Dependence Outpatient Rehabilitation programs, and Outpatient Youth programs will continue to bill using their APG rate code and enter appropriate HCPCS/CPT service codes on the line level for the services that were provided to the client on that service date/visit. Reimbursement for the APG coded claim will continue to be paid using APG reimbursement methodology (including applying APG discounts when appropriate). For a listing of service codes, please refer to the on-line APG manual at: http://www.oasas.ny.gov/admin/hcf/APG/documents/APGManual.pdf.

For claims with dates of service prior to January 1, 2014 and are submitted after January 1, 2014, these claims will have the Phase three legacy blend applied to the reimbursement.

Note: Hospital-based Chemical Dependence Outpatient clinics, Chemical Dependence Outpatient Rehabilitation programs, and Outpatient Youth programs continue to be reimbursed the threshold/legacy amount.

If you have any questions regarding this notification, please e-mail the APG mailbox at APG@oasas.ny.gov

Speak Your Mind

*