NYS DOH "Statewide Base Rate APGs"
Revised for January 1, 2014 Updates:
Informationrevisedsincethelastupdateishighlighted.
APG
97
218
223
250
281
282
283
286
287
290
291
292
293
294
295
296
297
298
299
300
301
302
303
385
390
391
392
393
394
395
396
397
398
399
400
401
402
403
404
Page 1 of 2
APG Description
AICD IMPLANT
LEVEL II NERVE PROCEDURES
LEVEL III NERVE PROCEDURES
COCHLEAR DEVICE IMPLANTATION
MAGNETIC RESONANCE ANGIOGRAPHY ‐ HEAD AND/OR NECK
MAGNETIC RESONANCE ANGIOGRAPHY ‐ CHEST
MAGNETIC RESONANCE ANGIOGRAPHY ‐ OTHER SITES
MAMMOGRAPHY
DIGESTIVE RADIOLOGY
PET SCANS
BONE DENSITOMETRY
MRI‐ ABDOMEN
MRI‐ JOINTS
MRI‐ BACK
MRI‐ CHEST
MRI‐ OTHER
MRI‐ BRAIN
CAT SCAN BACK
CAT SCAN ‐ BRAIN
CAT SCAN ‐ ABDOMEN
CAT SCAN ‐ OTHER
ANGIOGRAPHY, OTHER
ANGIOGRAPHY, CEREBRAL
MOLECULAR AND GENETIC TESTS
LEVEL I PATHOLOGY
LEVEL II PATHOLOGY
PAP SMEARS
BLOOD AND TISSUE TYPING
LEVEL I IMMUNOLOGY TESTS
LEVEL II IMMUNOLOGY TESTS
LEVEL I MICROBIOLOGY TESTS
LEVEL II MICROBIOLOGY TESTS
LEVEL I ENDOCRINOLOGY TESTS
LEVEL II ENDOCRINOLOGY TESTS
LEVEL I CHEMISTRY TESTS
LEVEL II CHEMISTRY TESTS
BASIC CHEMISTRY TESTS
ORGAN OR DISEASE ORIENTED PANELS
TOXICOLOGY TESTS
Date added to list 1/1/2011
1/1/2012
4/1/2011
1/1/2011
1/1/2011
1/1/2011
1/1/2011
1/1/2011
1/1/2011
1/1/2011
1/1/2011
1/1/2011
1/1/2011
1/1/2011
1/1/2011
1/1/2011
1/1/2011
1/1/2011
1/1/2011
1/1/2011
1/1/2011
1/1/2011
1/1/2011
1/1/2014
1/1/2011
1/1/2011
1/1/2011
1/1/2011
1/1/2011
1/1/2011
1/1/2011
1/1/2011
1/1/2011
1/1/2011
1/1/2011
1/1/2011
1/1/2011
1/1/2011
1/1/2011
State BR APGs
APG
405
406
407
408
409
410
411
414
415
416
430
431
432
433
434
435
436
437
438
439
440
441
443
444
455
460
461
462
463
464
465
471
Page 2 of 2
APG Description
THERAPEUTIC DRUG MONITORING
LEVEL I CLOTTING TESTS
LEVEL II CLOTTING TESTS
LEVEL I HEMATOLOGY TESTS
LEVEL II HEMATOLOGY TESTS
URINALYSIS
BLOOD AND URINE DIPSTICK TESTS
LEVEL I IMMUNIZATION AND ALLERGY IMMUNOTHERAPY
LEVEL II IMMUNIZATION
LEVEL III IMMUNIZATION
CLASS I CHEMOTHERAPY DRUGS
CLASS II CHEMOTHERAPY DRUGS
CLASS III CHEMOTHERAPY DRUGS
CLASS IV CHEMOTHERAPY DRUGS
CLASS V CHEMOTHERAPY DRUGS
CLASS I PHARMACOTHERAPY
CLASS II PHARMACOTHERAPY
CLASS III PHARMACOTHERAPY
CLASS IV PHARMACOTHERAPY
CLASS V PHARMACOTHERAPY
CLASS VI PHARMACOTHERAPY
CLASS VI CHEMOTHERAPY DRUGS
CLASS VII CHEMOTHERAPY DRUGS
CLASS VII PHARMACOTHERAPY
IMPLANTED TISSUE OF ANY TYPE
CLASS VIII COMBINED CHEMOTHERAPY AND PHARMACOTHERAPY
CLASS IX COMBINED CHEMOTHERAPY AND PHARMACOTHERAPY
CLASS X COMBINED CHEMOTHERAPY AND PHARMACOTHERAPY
CLASS XI COMBINED CHEMOTHERAPY AND PHARMACOTHERAPY
CLASS XII COMBINED CHEMOTHERAPY AND PHARMACOTHERAPY
CLASS XIII COMBINED CHEMOTHERAPY AND PHARMACOTHERAPY
PLAIN FILM
Date added to list 1/1/2011
1/1/2011
1/1/2011
1/1/2011
1/1/2011
1/1/2011
1/1/2011
1/1/2011
1/1/2011
1/1/2011
1/1/2011
1/1/2011
1/1/2011
1/1/2011
1/1/2011
1/1/2011
1/1/2011
1/1/2011
1/1/2011
1/1/2011
1/1/2011
1/1/2011
1/1/2011
1/1/2011
1/1/2011
1/1/2011
1/1/2011
1/1/2011
1/1/2011
1/1/2011
1/1/2011
1/1/2011
State BR APGs