Ambulatory Patient Groups (APGs)

Ambulatory Care Payment Reform

The Department has been authorized by state statute to implement a new outpatient payment system, Ambulatory Patient Groups (APGs) for Article 28 facilities.

The APG payment methodology will be used to reimburse providers as follows:

    DOH (Article 28)
    1. Hospital Outpatient Departments (other than Emergency Service) for services provided on dates of service on and after December 1, 2008.
    2. Hospital Emergency Service Department for services provided on dates of service on and after January 1, 2009.
    3. Freestanding diagnostic and treatment centers and ambulatory surgery centers for services provided on dates of service on and after September 1, 2009.
    OASAS (Article 32)
    1. Hospital-based OASAS Chemical Dependent Outpatient Clinics for services provided on dates of service on and after October 1, 2010.
    2. Hospital-based OASAS Outpatient Rehab Clinics and Opioid Treatment Program Clinics for services provided on dates of service on and after January 1, 2011.
    3. Freestanding OASAS Clinics for services provided on dates of service on and after July 1, 2011.
    OMH (Article 31)
    1. Hospital-based OMH Clinics for services provided on dates of service on and after October 1, 2010.
    2. Freestanding OMH Clinics for services provided on dates of service on and after October 1, 2010.
    OPWDD (Article 16)
    1. Hospital-based Article 16 Clincs for services provided on dates of service on and after July 1, 2011.
    2. Freestanding Article 16 Clinics for services provided on dates of service on and after July 1, 2011.

The information provided within the links on the left-hand side of this page will provide details regarding rates, reimbursement components, regulations, policies and APG weights.