Freestanding APG Base Rates Using Full APG Investment

Peer Group ∗∗Base Rate Code ∗∗∗Blend Rate Code Capital Rate Code Region 09/01/2009 12/01/2009 01/01/2010 07/01/2010 01/01/2011 04/01/2011 07/01/2011 01/01/2012 07/01/2012
Academic Dental 1428 1430 1431 Downstate $ 268.35 $ 238.33 $ 188.14 $ 188.14 $ 165.43 $ 162.12 $ 162.12 $ 155.38 $ 155.38
Academic Dental 1428 1430 1431 Upstate $ 223.22 $ 195.34 $ 169.16 $ 169.16 $ 158.90 $ 155.72 $ 155.72 $ 147.64 $ 147.64
Academic Dental Episode 1459 1460 1461 Downstate $ 162.12 $ 155.38 $ 155.38
Academic Dental Episode 1459 1460 1461 Upstate $ 155.72 $ 147.64 $ 147.64
Amb Surg 1408 1412 1410 Downstate $ 88.69 $ 88.69 $ 116.24 $ 116.24 $ 116.24 $ 113.92 $ 113.92 $ 113.92 $ 113.92
Amb Surg 1408 1412 1410 Upstate $ 86.39 $ 86.39 $ 101.18 $ 101.18 $ 101.18 $ 99.15 $ 99.15 $ 99.15 $ 99.15
Clinic∗ 1407 1411 1409 Downstate $ 212.07 $ 191.27 $ 195.41 $ 181.55 $ 168.91 $ 165.53 $ 170.66 $ 162.19 $ 165.64
Clinic∗ 1407 1411 1409 Upstate $ 174.74 $ 155.29 $ 163.77 $ 152.15 $ 141.56 $ 138.73 $ 143.03 $ 135.92 $ 138.81
Clinic Episode∗ 1422 1423 1424 Downstate $ 170.66 $ 162.19 $ 165.64
Clinic Episode∗ 1422 1423 1424 Upstate $ 143.03 $ 135.92 $ 138.81
Clinic MR/DD/TBI 1435 / 1495 1436 / 1496 1437 / 1497 Downstate $ 254.48 $ 229.52 $ 234.49 $ 217.86 $ 202.70 $ 198.64 $ 204.80 $ 194.62 $ 198.76
Clinic MR/DD/TBI 1435 / 1495 1436 / 1496 1437 / 1497 Upstate $ 209.69 $ 186.34 $ 196.52 $ 182.58 $ 169.87 $ 166.47 $ 171.63 $ 163.11 $ 166.58
Clinic MR/DD/TBI Episode 1425 / 1498 1426 / 1499 1427 / 1500 Downstate $ 204.80 $ 194.62 $ 198.76
Clinic MR/DD/TBI Episode 1425 / 1498 1426 / 1499 1427 / 1500 Upstate $ 171.63 $ 163.11 $ 166.58
Renal 1438 1439 1440 Downstate $ 235.70 $ 197.58 $ 206.89 $ 179.20 $ 155.85 $ 152.73 $ 152.73 $ 141.29 $ 141.29
Renal 1438 1439 1440 Upstate $ 196.06 $ 161.95 $ 191.07 $ 165.50 $ 141.44 $ 138.61 $ 138.61 $ 126.82 $ 126.82
Renal Episode 1456 1457 1458 Downstate $ 152.73 $ 141.29 $ 141.29
Renal Episode 1456 1457 1458 Upstate $ 138.61 $ 126.82 $ 126.82
School-Based Health Center (SBHC)∗ 1447 1448 1449 Downstate $ 212.07 $ 191.27 $ 195.41 $ 181.55 $ 168.91 $ 165.53 $ 170.66 $ 162.19 $ 165.64
School-Based Health Center (SBHC)∗ 1447 1448 1449 Upstate $ 174.74 $ 155.29 $ 163.77 $ 152.15 $ 141.56 $ 138.73 $ 143.03 $ 135.92 $ 138.81
SBHC Episode∗ 1453 1454 1455 Downstate $ 170.66 $ 162.19 $ 165.64
SBHC Episode∗ 1453 1454 1455 Upstate $ 143.03 $ 135.92 $ 138.81
∗For Clinic and School-Based Health Center [SBHC], while they share the same base payment rates, please note that their rate codes differ.
∗∗Schedule provides Base Rates only. For the Existing Rate for Blend and Capital Add-on rates, refer to the Rate by Provider files.
∗∗∗The Blend (Existing Rate for Blend) rates were set to $0 effective 1/1/2012 as the APG payment now reflects 100% of the Base rate.
The rate effective 4/1/2011 has been reduced by 2% for the Across-the-Board reduction.
Out-of-State Freestanding Providers use the same Rate Codes and Base Rates as NYS Freestanding Providers
Rates not available during this time period.