Hospital Out of State APG Rates

Peer Group Rate Rate Code 07/01/2009 10/01/2009 12/01/2009 01/01/2010 07/01/2010 10/01/2010 01/01/2011 04/01/2011 07/01/2011 01/01/2012 05/01/2012
DOWNSTATE RATES:
Amb Surg Base 1416 $156.91 $156.91 $156.91 $228.00 $215.50 $215.50 $197.29 $197.29 $195.59 $195.59 $195.59
Amb Surg Capital 1418 $115.70 $115.70 $115.70 $115.70 $115.70 $115.70 $115.70 $115.70 $115.70 $115.70 $115.70
Clinic∗ Base 1413 $258.90 $258.90 $274.23 $304.39 $325.95 $313.50 $240.17 $224.47 $231.93 $199.89 $183.53
Clinic∗ Blend 1414 $129.67 $129.67 $129.67 $129.67 $129.67 $129.67 $129.67 $129.67 $129.67 $0.00 $0.00
Clinic∗ Capital 1415 $18.13 $18.13 $18.13 $18.13 $18.13 $18.13 $18.13 $18.13 $18.13 $18.13 $18.13
Clinic Episode∗ Base 1441 $258.90 $274.23 $304.39 $325.95 $313.50 $240.17 $224.47 $231.93 $199.89 $183.53
Clinic Episode∗ Blend 1442 $129.67 $129.67 $129.67 $129.67 $129.67 $129.67 $129.67 $129.67 $0.00 $0.00
Clinic Episode∗ Capital 1443 $18.13 $18.13 $18.13 $18.13 $18.13 $18.13 $18.13 $18.13 $18.13 $18.13
Clinic MR/DD/TBI∗[1] Base 1501 $325.95 $313.50 $240.17 $224.47 $231.93 $199.89 $183.53
Clinic MR/DD/TBI∗[1] Blend 1502 $129.67 $129.67 $129.67 $129.67 $129.67 $0.00 $0.00
Clinic MR/DD/TBI∗[1] Capital 1503 $18.13 $18.13 $18.13 $18.13 $18.13 $18.13 $18.13
Clinic MR/DD/TBI Episode∗[1] Base 1489 $325.95 $313.50 $240.17 $224.47 $231.93 $199.89 $183.53
Clinic MR/DD/TBI Episode∗[1] Blend 1490 $129.67 $129.67 $129.67 $129.67 $129.67 $0.00 $0.00
Clinic MR/DD/TBI Episode∗[1] Capital 1491 $18.13 $18.13 $18.13 $18.13 $18.13 $18.13 $18.13
Emergency Department Base 1419 $175.11 $175.11 $175.11 $196.94 $184.98 $184.98 $184.98 $193.41 $197.38 $197.38 $197.38
Emergency Department Capital 1421 $22.61 $22.61 $22.61 $22.61 $22.61 $22.61 $22.61 $22.61 $22.61 $22.61 $22.61
UPSTATE RATES:
Amb Surg Out of State Base 1416 $122.55 $122.55 $122.55 $176.13 $166.47 $166.47 $152.41 $152.41 $151.09 $151.09 $151.09
Amb Surg Out of State Capital 1418 $108.48 $108.48 $108.48 $108.48 $108.48 $108.48 $108.48 $108.48 $108.48 $108.48 $108.48
Clinic∗ Base 1413 $199.00 $199.00 $210.79 $233.97 $249.56 $240.98 $184.61 $172.54 $178.28 $153.65 $140.52
Clinic∗ Blend 1414 $92.61 $92.61 $92.61 $92.61 $92.61 $92.61 $92.61 $92.61 $92.61 $0.00 $0.00
Clinic∗ Capital 1415 $12.16 $12.16 $12.16 $12.16 $12.16 $12.16 $12.16 $12.16 $12.16 $12.16 $12.16
Clinic Episode∗ Base 1441 $199.00 $210.79 $233.97 $249.56 $240.98 $184.61 $172.54 $178.28 $153.65 $140.52
Clinic Episode∗ Blend 1442 $92.61 $92.61 $92.61 $92.61 $92.61 $92.61 $92.61 $92.61 $0.00 $0.00
Clinic Episode∗ Capital 1443 $12.16 $12.16 $12.16 $12.16 $12.16 $12.16 $12.16 $12.16 $12.16 $12.16
Clinic MR/DD/TBI∗[1] Base 1501 $249.56 $240.98 $184.61 $172.54 $178.28 $153.65 $140.52
Clinic MR/DD/TBI∗[1] Blend 1502 $92.61 $92.61 $92.61 $92.61 $92.61 $0.00 $0.00
Clinic MR/DD/TBI∗[1] Capital 1503 $12.16 $12.16 $12.16 $12.16 $12.16 $12.16 $12.16
Clinic MR/DD/TBI Episode∗[1] Base 1489 $249.56 $240.98 $184.61 $172.54 $178.28 $153.65 $140.52
Clinic MR/DD/TBI Episode∗[1] Blend 1490 $92.61 $92.61 $92.61 $92.61 $92.61 $0.00 $0.00
Clinic MR/DD/TBI Episode∗[1] Capital 1491 $12.16 $12.16 $12.16 $12.16 $12.16 $12.16 $12.16
Emergency Department Base 1419 $135.27 $135.27 $135.27 $153.81 $144.47 $144.47 $144.47 $151.05 $154.15 $154.15 $154.15
Emergency Department Capital 1421 $13.84 $13.84 $13.84 $13.84 $13.84 $13.84 $13.84 $13.84 $13.84 $13.84 $13.84
∗For Clinic (effective 7/1/2009 & 10/1/2009) & MR/DD/TBI (effective 7/1/2010), while they share the same base payment rates, please note that their rate codes and effective dates differ.
∗∗∗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.
[1] MR/DD/TBI Rates: Currently do not receive the 20% increase (still waiting CMS approval). Rates are the same rates as clinic.
Rates not available during this time period..