WebJun 6, 2012 · The EAPG reimbursement methodology applies to fee-for-service members enrolled in BadgerCare Plus, Wisconsin Medicaid, and the Wisconsin Chronic Disease Program. EAPG was implemented for fee-for-service claims on April 1, 2013, and extended to HMO encounters on January 1, 2015. ForwardHealth continues to publish rate-per … WebApr 12, 2024 · The Enhanced Ambulatory Patient Groups (EAPG) system was implemented by ForwardHealth on April 1, 2013, to classify and calculate reimbursement …
EAPG Covered Codes (pdf) - Ohio
WebJun 22, 2024 · The EAPG payment methodology also allows for greater payment homogeneity for comparable services across all ambulatory care settings (i.e. outpatient … Webwere assigned by the EAPG grouper), times applicable discounting factors. • Refer to EAPG Relative Weights Table link at end of document. Q: Are there any items which may be paid outside of EAPG? A: Yes, select items may be paid outside of EAPG when they meet the criteria listed in . OAC 5160-2-75. Some examples are: • Pharmaceuticals highest rated geodes online
EAPG Covered Codes (pdf) - Ohio
WebJan 1, 2024 · EAPG payment is based on the severity of an episode of care. The 2015 EAPG fee schedule has a NYS Workers' Compensation specific base rate that pays … WebJan 19, 2010 · is multiplied by a conversion factor to yield the EAPG payment amount. DC Medicaid also has a 1.15 pediatric policy adjustor for FY 2024. This is applied as a percent increase on claims for beneficiaries under the age of 21. EAPG Payment Calculation EAPG payment = (Adjusted EAPG relative weight * pediatric policy adjustor) * conversion factor WebJun 6, 2012 · The EAPG reimbursement methodology applies to fee-for-service members enrolled in BadgerCare Plus, Wisconsin Medicaid, and the Wisconsin Chronic Disease … how harvard rules