Hospital APG Base Rates Using Full APG Investment
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| Peer Group | **Base Rate Code | ***Blend Rate Code | Capital Rate Code | Region | 12/01/08 | 01/01/09 | 04/01/09 | 07/01/09 | 10/01/09 | 12/01/09 | 01/01/10 | 07/01/10 | 10/01/10 | 01/01/11 | 04/01/11 | 07/01/11 | 01/01/12 | 05/01/12 | 07/01/14 | 07/01/16 | 04/01/22 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Amb Surg | 1401 | NA | 1404 | Downstate | $162.53 | $162.53 | $162.53 | $156.91 | $156.91 | $156.91 | $228.00 | $215.50 | $215.50 | $197.29 | $197.29 | $195.59 | $195.59 | $195.59 | $195.59 | $ 195.59 | $ 197.55 |
| Amb Surg | 1401 | NA | 1404 | Upstate | $132.04 | $132.04 | $132.04 | $122.55 | $122.55 | $122.55 | $176.13 | $166.47 | $166.47 | $152.41 | $152.41 | $151.09 | $151.09 | $151.09 | $151.09 | $151.09 | $152.60 |
| Clinic* | 1400 | 1406 | 1403 | Downstate | $276.38 | $276.38 | $276.38 | $258.90 | $258.90 | $274.23 | $304.39 | $325.95 | $313.50 | $240.17 | $224.47 | $231.93 | $199.89 | $183.53 | $183.53 | $ 183.53 | $ 185.37 |
| Clinic* | 1400 | 1406 | 1403 | Upstate | $219.69 | $219.69 | $219.69 | $199.00 | $199.00 | $210.79 | $233.97 | $249.56 | $240.98 | $184.61 | $172.54 | $178.28 | $153.65 | $140.52 | $140.52 | $140.52 | $141.93 |
| Clinic Episode* | 1432 | 1433 | 1434 | Downstate | $258.90 | $258.90 | $274.23 | $304.39 | $325.95 | $313.50 | $240.17 | $224.47 | $231.93 | $199.89 | $183.53 | $183.53 | $183.53 | $185.37 | |||
| Clinic Episode* | 1432 | 1433 | 1434 | Upstate | $199.00 | $199.00 | $210.79 | $233.97 | $249.56 | $240.98 | $184.61 | $172.54 | $178.28 | $153.65 | $140.52 | $140.52 | $140.52 | $141.93 | |||
| Clinic MR/DD/TBI*[1] | 1501 | 1502 | 1503 | Downstate | $391.14 | $376.20 | $288.20 | $269.36 | $278.32 | $239.87 | $220.23 | $220.23 | $220.23 | $222.43 | |||||||
| Clinic MR/DD/TBI*[1] | 1501 | 1502 | 1503 | Upstate | $299.47 | $289.17 | $221.53 | $207.05 | $213.94 | $184.38 | $168.63 | $168.63 | $168.63 | $170.32 | |||||||
| Clinic MR/DD/TBI Episode*[1] | 1489 | 1490 | 1491 | Downstate | $391.14 | $376.20 | $288.20 | $269.36 | $278.32 | $239.87 | $220.23 | $220.23 | $220.23 | $222.43 | |||||||
| Clinic MR/DD/TBI Episode*[1] | 1489 | 1490 | 1491 | Upstate | $299.47 | $289.17 | $221.53 | $207.05 | $213.94 | $184.38 | $168.63 | $168.63 | $168.63 | $170.32 | |||||||
| Emergency Department (ED) | 1402 | NA | 1405 | Downstate | $189.15 | $189.15 | $175.11 | $175.11 | $175.11 | $196.94 | $184.98 | $184.98 | $184.98 | $193.41 | $197.38 | $197.38 | $197.38 | $197.38 | $197.38 | $199.35 | |
| Emergency Department (ED) | 1402 | NA | 1405 | Upstate | $152.04 | $152.04 | $135.27 | $135.27 | $135.27 | $153.81 | $144.47 | $144.47 | $144.47 | $151.05 | $154.15 | $154.15 | $154.15 | $154.15 | $154.15 | $155.69 | |
| School-Based Health Center (SBHC)* | 1444 | 1445 | 1446 | Downstate | $276.38 | $258.90 | $258.90 | $274.23 | $304.39 | $325.95 | $313.50 | $240.17 | $224.47 | $231.93 | $199.89 | $183.53 | $183.53 | $183.53 | $185.37 | ||
| School-Based Health Center (SBHC)* | 1444 | 1445 | 1446 | Upstate | $219.69 | $199.00 | $199.00 | $210.79 | $233.97 | $249.56 | $240.98 | $184.61 | $172.54 | $178.28 | $153.65 | $140.52 | $140.52 | $140.52 | $141.93 | ||
| SBHC Episode* | 1450 | 1451 | 1452 | Downstate | $258.90 | $274.23 | $304.39 | $325.95 | $313.50 | $240.17 | $224.47 | $231.93 | $199.89 | $183.53 | $183.53 | $183.53 | $185.37 | ||||
| SBHC Episode* | 1450 | 1451 | 1452 | Upstate | $199.00 | $210.79 | $233.97 | $249.56 | $240.98 | $184.61 | $172.54 | $178.28 | $153.65 | $140.52 | $140.52 | $140.52 | $141.93 |
*For Clinic (effective 12/1/2008) & School-Based Health Center [SBHC] (effective 4/1/2009), while they share the same base payment rates, please note that their rate codes and effective dates 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.
[1] MR/DD/TBI Rates: Clinic rate increased by 20%. Rate increase is effective 7/1/2010.
Rates not available during this time period.
