2025 APR-DRG and Exempt Rates for Medicaid Fee-for-Service and Managed Care
Effective 04/01/2025 (Initial Rates)
- Medicaid Managed Care
- APR-DRG and Exempt Unit Rates effective 04/01/2025 (XLSX) | Also available in PDF Format - Updated 02/24/2026
- DOH Medicaid FFS and HMO Claims Payment Calculation (XLSX) | Also available in PDF Format
- Correspondence
- Health Plan Letter - October 16, 2025
Effective 01/01/2025 (Initial Rates)
- Medicaid Fee-for-Service
- APR-DRG and Exempt Unit Rates effective 01/01/2025 (XLSX) | Also available in PDF Format - Updated 02/24/2026
- DOH Medicaid FFS and HMO Claims Payment Calculation (XLSX) | Also available in PDF Format - Updated 03/06/2026
- Chemical Dependency Detoxification Rates (XLSX) | Also available in PDF Format - 01/01/2025
- Medicaid Managed Care
- APR-DRG and Exempt Unit Rates effective 01/01/2025 (XLSX) | Also available in PDF Format - Updated 03/06/2026
- DOH Medicaid FFS and HMO Claims Payment Calculation (XLSX) | Also available in PDF Format - Updated 03/06/2026
- Chemical Dependency Detoxification Rates (XLSX) | Also available in PDF Format - 01/01/2025
- Correspondence
- Administrator Letter PDF Format - July 14, 2025
- Health Plan Letter PDF Format - July 18, 2025
- Health Plan Letter - March 06, 2026
