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New York Healthcare Reform: APGs and APR-DRGs

New York State Medicaid has adopted the 3M's Enhanced Ambulatory Patient Group (EAPG) payment methodology for hospital outpatient services and All Patient Refined Diagnosis Related Groups (APR-DRGs) for inpatient services. Understand how these reforms affect your hospital.

  • Reimbursement and Compliant Billing are directly affected by correct coding. Payments for medical visits now vary based on diagnosis coding. In addition, HCPCS/CPT codes are required for all Procedures, Therapies and Ancillaries.
  • Operational Issues such as rate code selection and scheduling can impact payment.
Partner With PCS to Tailor Your Solutions

One size doesn't fit all. PCS is the leading consulting firm in New York State, specializing in Medicare and Medicaid reimbursement methodology. Put PCS' expertise to work for you with a customized plan that fits your facility's needs.

  • Data Analysis, Departmental Review, and Reimbursement Modeling
  • Coding and Billing Audits
  • Operational Assessments
  • Education and Training
Partner with PCS.

Contact us today to review your current hospital Medicaid remittance data.




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