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Workers' Compensation Board

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New York State
Workers' Compensation Board
OFFICE OF THE CHAIR
328 State Street  Schenectady, New York 12305
Governor Andrew M. Cuomo


Subject No. 046-829

New York Workers’ Compensation Board Offering
Ambulatory Surgery Fee Schedule Webinar Training

Date: November 12, 2015

As announced in Subject No. 046-784, Board Files Ambulatory Surgery Fee Schedule Regulations, the Board has implemented an Ambulatory Patient Group (APG) based Ambulatory Surgery Fee Schedule. To ease the transition to the new fee schedule, the Board will be offering training via webinar targeted at medical billing and coding staff for carriers, TPAs and medical facilities.

Webinar Training

The Board, in conjunction with 3M, will be offering three webinar trainings. These trainings will be held on the following dates:

  • November 13, 2015 2:00 pm to 3:30 pm
  • December 2, 2015 10:30 am to 12:00 pm
  • December 4, 2015 2:00 pm to 3:30 pm

Additional information can be found on the Board’s Outreach Calendar.

3M produces a software product that performs the calculations required for reimbursement under the EAPG methodology. The October 29th release of the 3M Core Grouper and NYS Outpatient tables included the regulatory updates for the transition to EAPGs for New York State workers’ compensation related ambulatory surgery billing. Use of the 3M software for calculating reimbursement, however, is optional. The reimbursement rates can be calculated manually.

Manual Calculations

Directions for calculating APG rates without the 3M Core Grouper software can be found in the Policy and Billing Guidance Ambulatory Patient Groups (APGs) Provider Manual located on the Department of Health’s (DOH) website,

https://www.health.ny.gov/health_care/medicaid/rates/apg/docs/apg_provider_manual.pdfLink to External Website

Resources necessary for manual calculations can be found on the DOH’s website Ambulatory Patient Groups homepage, https://www.health.ny.gov/health_care/medicaid/rates/apg/Link to External Website

Medical billing and coding staff will also need to review and utilize the Board’s Ambulatory Surgery fee schedule transition document on the Board’s website, under 2015 Medical Fee Schedules.

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Robert E. Beloten
Chair