Academic Dental |
1428 |
1430 |
1431 |
Downstate |
$ 268.35 |
$ 238.33 |
$ 188.14 |
$ 188.14 |
$ 165.43 |
$ 162.12 |
$ 162.12 |
$ 155.38 |
$ 155.38 |
$ 158.55 |
$ 160.14 |
Academic Dental |
1428 |
1430 |
1431 |
Upstate |
$ 223.22 |
$ 195.34 |
$ 169.16 |
$ 169.16 |
$ 158.90 |
$ 155.72 |
$ 155.72 |
$ 147.64 |
$ 147.64 |
$ 150.65 |
$ 152.16 |
Academic Dental Episode |
1459 |
1460 |
1461 |
Downstate |
|
|
|
|
|
|
$ 162.12 |
$ 155.38 |
$ 155.38 |
$ 158.55 |
$ 160.14 |
Academic Dental Episode |
1459 |
1460 |
1461 |
Upstate |
|
|
|
|
|
|
$ 155.72 |
$ 147.64 |
$ 147.64 |
$ 150.65 |
$ 152.16 |
Amb Surg |
1408 |
1412 |
1410 |
Downstate |
$ 88.69 |
$ 88.69 |
$ 116.24 |
$ 116.24 |
$ 116.24 |
$ 113.92 |
$ 113.92 |
$ 113.92 |
$ 113.92 |
$ 116.24 |
$ 117.40 |
Amb Surg |
1408 |
1412 |
1410 |
Upstate |
$ 86.39 |
$ 86.39 |
$ 101.18 |
$ 101.18 |
$ 101.18 |
$ 99.15 |
$ 99.15 |
$ 99.15 |
$ 99.15 |
$ 101.17 |
$ 102.18 |
Clinic* |
1407 |
1411 |
1409 |
Downstate |
$ 212.07 |
$ 191.27 |
$ 195.41 |
$ 181.55 |
$ 168.91 |
$ 165.53 |
$ 170.66 |
$ 162.19 |
$ 165.64 |
$ 169.02 |
$ 170.71 |
Clinic* |
1407 |
1411 |
1409 |
Upstate |
$ 174.74 |
$ 155.29 |
$ 163.77 |
$ 152.15 |
$ 141.56 |
$ 138.73 |
$ 143.03 |
$ 135.92 |
$ 138.81 |
$ 141.64 |
$ 143.06 |
Clinic Episode* |
1422 |
1423 |
1424 |
Downstate |
|
|
|
|
|
|
$ 170.66 |
$ 162.19 |
$ 165.64 |
$ 169.02 |
$ 170.71 |
Clinic Episode* |
1422 |
1423 |
1424 |
Upstate |
|
|
|
|
|
|
$ 143.03 |
$ 135.92 |
$ 138.81 |
$ 141.64 |
$ 143.06 |
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 |
$ 202.82 |
$ 204.85 |
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 |
$ 169.98 |
$ 171.68 |
Clinic MR/DD/TBI Episode |
1425 / 1498 |
1426 / 1499 |
1427 / 1500 |
Downstate |
|
|
|
|
|
|
$ 204.80 |
$ 194.62 |
$ 198.76 |
$ 202.82 |
$ 204.85 |
Clinic MR/DD/TBI Episode |
1425 / 1498 |
1426 / 1499 |
1427 / 1500 |
Upstate |
|
|
|
|
|
|
$ 171.63 |
$ 163.11 |
$ 166.58 |
$ 169.98 |
$ 171.68 |
Renal |
1438 |
1439 |
1440 |
Downstate |
$ 235.70 |
$ 197.58 |
$ 206.89 |
$ 179.20 |
$ 155.85 |
$ 152.73 |
$ 152.73 |
$ 141.29 |
$ 141.29 |
$ 144.17 |
$ 145.61 |
Renal |
1438 |
1439 |
1440 |
Upstate |
$ 196.06 |
$ 161.95 |
$ 191.07 |
$ 165.50 |
$ 141.44 |
$ 138.61 |
$ 138.61 |
$ 126.82 |
$ 126.82 |
$ 129.41 |
$ 130.70 |
Renal Episode |
1456 |
1457 |
1458 |
Downstate |
|
|
|
|
|
|
$ 152.73 |
$ 141.29 |
$ 141.29 |
$ 144.17 |
$ 145.61 |
Renal Episode |
1456 |
1457 |
1458 |
Upstate |
|
|
|
|
|
|
$ 138.61 |
$ 126.82 |
$ 126.82 |
$ 129.41 |
$ 130.70 |
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 |
$ 169.02 |
$ 170.71 |
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 |
$ 141.64 |
$ 143.06 |
SBHC Episode* |
1453 |
1454 |
1455 |
Downstate |
|
|
|
|
|
|
$ 170.66 |
$ 162.19 |
$ 165.64 |
$ 169.02 |
$ 170.71 |
SBHC Episode* |
1453 |
1454 |
1455 |
Upstate |
|
|
|
|
|
|
$ 143.03 |
$ 135.92 |
$ 138.81 |
$ 141.64 |
$ 143.06 |
*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 |
****Effective April 1, 2022 the Medicaid Ambulatory Patient Group (APG) base rates have been increased by 1% in accordance with the State Fiscal Year 2022/2023 Budget. |
|
|
Rates not available during this time period. |