NYS DOH ‐ If Stand Alone, Do Not Pay APGs Under APG Reimbursement
Revised for January 1, 2015 Updates:
Note: Informationrevisedduringthequarterlyupdateperiodstatedaboveishighlighted
APG Desc
APG
APG Type
2011 APG type
Date code added to ISADNP list
118
280
281
282
283
284
285
286
287
288
289
290
291
292
293
294
Nutrition Therapy
Vascular Radiology Except Venography Of Extremity
Magnetic Resonance Angiography ‐ Head And/Or Neck
Magnetic Resonance Angiography ‐ Chest
Magnetic Resonance Angiography ‐ Other Sites
Myelography
Miscellaneous Radiological Procedures With Contrast
Mammography
Digestive Radiology
Diagnostic Ultrasound Except Obstetrical And Vascular Of Lower Vascular Diagnostic Ultrasound Of Lower Extremities
Pet Scans
Bone Densitometry
Mri‐ Abdomen
Mri‐ Joints
Mri‐ Back
Significant Proc.
Significant Proc.
Significant Proc.
Significant Proc.
Significant Proc.
Significant Proc.
Significant Proc.
Significant Proc.
Significant Proc.
Significant Proc.
Significant Proc.
Significant Proc.
Significant Proc.
Significant Proc.
Significant Proc.
Significant Proc.
Physical Therapy & Rehab
Radiologic Procedure
Radiologic Procedure
Radiologic Procedure
Radiologic Procedure
Radiologic Procedure
Radiologic Procedure
Radiologic Procedure
Radiologic Procedure
Radiologic Procedure
Radiologic Procedure
Radiologic Procedure
Radiologic Procedure
Radiologic Procedure
Radiologic Procedure
Radiologic Procedure
295
Mri‐ Chest
Significant Proc.
Radiologic Procedure
1/1/2010
296
Mri‐ Other
Significant Proc.
Radiologic Procedure
1/1/2010
297
Mri‐ Brain
Significant Proc.
Radiologic Procedure
1/1/2010
298
Cat Scan Back
Significant Proc.
Radiologic Procedure
12/1/2008
299
Cat Scan ‐ Brain
Significant Proc.
Radiologic Procedure
12/1/2008
300
Cat Scan ‐ Abdomen
Significant Proc.
Radiologic Procedure
12/1/2008
301
Cat Scan ‐ Other
Significant Proc.
Radiologic Procedure
12/1/2008
302
Angiography, Other
Significant Proc.
Radiologic Procedure
12/1/2008
303
Angiography, Cerebral
Significant Proc.
Radiologic Procedure
12/1/2008
330
Level I Diagnostic Nuclear Medicine
Significant Proc.
Radiologic Procedure
12/1/2008
331
Level II Diagnostic Nuclear Medicine
Significant Proc.
Radiologic Procedure
12/1/2008
332
Level III Diagnostic Nuclear Medicine
Significant Proc.
Radiologic Procedure
12/1/2008
373
Level I Dental Film
Ancillary
Ancillary
1/1/2010
374
Level II Dental Film
Ancillary
Ancillary
1/1/2010
375
Dental Anesthesia
Ancillary
Ancillary
1/1/2010
380
Anesthesia
Ancillary
Ancillary
12/1/2008
390
Level I Pathology
Ancillary
Ancillary
12/1/2008
391
Level II Pathology
Ancillary
Ancillary
12/1/2008
392
Pap Smears
Ancillary
Ancillary
12/1/2008
393
Blood And Tissue Typing
Ancillary
Ancillary
12/1/2008
394
Level I Immunology Tests
Ancillary
Ancillary
12/1/2008
395
Level II Immunology Tests
Ancillary
Ancillary
12/1/2008
396
Level I Microbiology Tests
Ancillary
Ancillary
12/1/2008
397
Level II Microbiology Tests
Ancillary
Ancillary
12/1/2008
398
Level I Endocrinology Tests
Ancillary
Ancillary
12/1/2008
399
Level II Endocrinology Tests
Ancillary
Ancillary
12/1/2008
1/1/2010
12/1/2008
1/1/2010
1/1/2010
1/1/2010
12/1/2008
12/1/2008
12/1/2008
12/1/2008
12/1/2008
12/1/2008
12/1/2008
12/1/2008
1/1/2010
1/1/2010
1/1/2010
400
Level I Chemistry Tests
Ancillary
Ancillary
12/1/2008
401
Level II Chemistry Tests
Ancillary
Ancillary
12/1/2008
402
Basic Chemistry Tests
Ancillary
Ancillary
12/1/2008
403
Organ Or Disease Oriented Panels
Ancillary
Ancillary
12/1/2008
404
Toxicology Tests
Ancillary
Ancillary
12/1/2008
405
Therapeutic Drug Monitoring
Ancillary
Ancillary
12/1/2008
Page 1 of 2
Date code removed form ISADNP list
1/1/2011
1/1/2010
APG Desc
APG
APG Type
406
Level I Clotting Tests
Ancillary
407
Level II Clotting Tests
408
Level I Hematology Tests
409
2011 APG type
Date code added to ISADNP list
Date code removed form ISADNP list
Ancillary
12/1/2008
Ancillary
Ancillary
12/1/2008
Ancillary
Ancillary
12/1/2008
Level II Hematology Tests
Ancillary
Ancillary
12/1/2008
410
Urinalysis
Ancillary
Ancillary
12/1/2008
411
Blood And Urine Dipstick Tests
Ancillary
Ancillary
12/1/2008
413
Cardiogram
Ancillary
Ancillary
12/1/2008
414
Level I Immunization And Allergy Immunotherapy
Ancillary
Ancillary
12/1/2008
4/1/2009
415
Level II Immunization
Ancillary
Ancillary
12/1/2008
4/1/2009
416
Level III Immunization
Ancillary
Ancillary
12/1/2008
4/1/2009
420
Pacemaker And Other Electronic Analysis
Ancillary
Ancillary
12/1/2008
4/1/2009
435
Class I Pharmacotherapy
Drug
Drug
12/1/2008
436
437
Class II Pharmacotherapy
Class III Pharmacotherapy
Drug
Drug
Drug
Drug
12/1/2008
12/1/2008
438
Class IV Pharmacotherapy
Drug
Drug
12/1/2008
439
Class V Pharmacotherapy
Drug
Drug
12/1/2008
440
Class VI Pharmacotherapy
Drug
Drug
1/1/2010
444
CLASS VII PHARMACOTHERAPY
Drug
Drug
448
After Hours Services
Ancillary
Ancillary
12/1/2008
1/1/2015
451
455
457
460
Smoking Cessation Treatment
Ancillary
DME
Implanted Tissue Of Any Type
Ancillary
Venipuncture
CLASS VIII COMBINED CHEMOTHERAPY AND PHARMACOTHERAPY
Ancillary
DME
Ancillary
12/1/2008
12/1/2008
12/1/2008
7/1/2011
4/1/2011
461
CLASS IX COMBINED CHEMOTHERAPY AND PHARMACOTHERAPY
Drug
Drug
7/1/2011
462
CLASS X COMBINED CHEMOTHERAPY AND PHARMACOTHERAPY
Drug
Drug
7/1/2011
463
CLASS XI COMBINED CHEMOTHERAPY AND PHARMACOTHERAPY
Drug
Drug
7/1/2011
464
CLASS XII COMBINED CHEMOTHERAPY AND PHARMACOTHERAPY
Drug
Drug
7/1/2011
465
CLASS XIII COMBINED CHEMOTHERAPY AND PHARMACOTHERAPY Drug
Drug
7/1/2011
470
Obstetrical Ultrasound
Ancillary
Ancillary
12/1/2008
471
Plain Film
Ancillary
Ancillary
12/1/2008
472
Ultrasound Guidance
Ancillary
Ancillary
12/1/2008
473
Ct Guidance
Ancillary
Ancillary
12/1/2008
490
INCIDENTAL TO MEDICAL, SIGNIFICANT PROCEDURE OR THERAPY Incidental
VISIT
MINOR PHARMACOTHERAPY
Incidental
4/1/2011
Drug
7/1/2012
496
Page 2 of 2
7/1/2011