All Patient Refined Diagnosis Related Groups (APR-DRGs)
Hospital Inpatient Reimbursement Rate Reform Effective December 1, 2009
Effective December 1, 2009 the Department has been authorized by state statute to implement a new hospital inpatient payment system. To provide a more equitable and fair payment method for services being rendered, New York will be implementing a severity-based methodology using 3M ™ All Patient Refined Diagnosis Related Groups (APR-DRGs). In addition, a new acute care payment methodology has been developed.
The information provided within the links on the left-hand side of this page will provide details regarding implementation, weights and additional web resources pertaining to the APR grouper. Questions related to the new payment system can be directed to the Bureau of HCRA Operations and Financial Analysis electronic mailbox bhofamail@health.state.ny.us or via phone at 518-473-8822.
Updated Rates
- The Medicaid Managed Care and Workers' Compensation/No-Fault Initial rates for 10/01/2010 and 01/01/2011 have been updated 01/10/2012. These updates have been posted under the 2010 and 2011 "Rate Schedules" for Medicaid Managed Care and Workers' Compensation/No Fault.
- The Medicaid Fee-for-Service Revised rates for 10/01/2010 and 01/01/2011 have been added, as well as the Initial Medicaid Fee-for-Service and Medicaid Managed Care rates for 04/01/2011 and 10/01/2011. These rates have been posted under the 2010 and 2011 "Rate Schedules" for Medicaid Fee-for-Service and Medicaid Managed Care.
