Non-50% Discounting APG List
Revised for July 1, 2020 Updates:
- Also available in Excel Format (XLS) and Portable Document Format (PDF)
Information revised since the last update is highlighted.
Note: This list was first implemented in April 2010, retroactive to January 2010.
| APG | APG Description | Discount Percent if not 50% |
Effective Date added to the list | Effective Date removed to the list | Notes |
|---|---|---|---|---|---|
| 118 | NUTRITION THERAPY | 25% | Effective 1-1-10 | ||
| 257 | AUDIOMETRY | 25% | Effective 1-1-10 | ||
| 269 | LEVEL II ANCLLARY THERAPEUTIC SERVICES | 25% | Effective 7-1-20 | 25% discounting would be applied to only Article 16 APG rate code 1534, 1537, 1546, and 1549. | |
| 270 | OCCUPATIONAL THERAPY | 25% | Effective 1-1-10 | ||
| 271 | PHYSICAL THERAPY | 25% | Effective 1-1-10 | ||
| 272 | SPEECH THERAPY AND EVALUATION | 25% | Effective 1-1-10 | ||
| 274 | OCCUPATIONAL/PHYSICAL THERAPY, GROUP | 25% | Effective 1-1-10 | Effective 1-1-20 | |
| 275 | SPEECH THERAPY & EVALUATION, GROUP | 25% | Effective 1-1-10 | Effective 1-1-20 | |
| 310 | DEVELOPMENTAL & NEUROPSYCHOLOGICAL TESTING | 10% | Effective 1-1-10 | Effective 7/1/15, "Discount" would not be applied (100% will be paid) to the following APG rate codes; 1480, 1483, 1486, 1594, 1597, 1122, 1124, 1130, 1132, 1134. Effective 4/1/16, "Discount" would not be applied (100% will be paid) to the following APG rate codes; 1000, 1003, 1060, 1062, 1064, 1066, 1102, 1104, 1106, 1108, 1110, 1112, 1114, 1116, 1118, 1120. Effective 7/1/17, "Discount" would not be applied (100% will be paid) to the following APG rate codes; 1042, 1045, 1048, 1051. | |
| 312 | BEHAVIORAL AND SUBSTANCE ABUSE PARTIAL HOSPITALIZATION PROGRAM | 10% | Effective 1-1-10 | ||
| 315 | COUNSELLING OR INDIVIDUAL BRIEF PSYCHOTHERAPY | 10% | Effective 1-1-10 | Effective 7/1/15, "Discount" would not be applied (100% will be paid) to the following APG rate codes; 1480, 1483, 1486, 1594, 1597, 1122, 1124, 1130, 1132, 1134. Effective 4/1/16, "Discount" would not be applied (100% will be paid) to the following APG rate codes; 1000, 1003, 1060, 1062, 1064, 1066, 1102, 1104, 1106, 1108, 1110, 1112, 1114, 1116, 1118, 1120. Effective 7/1/17, "Discount" would not be applied (100% will be paid) to the following APG rate codes; 1042, 1045, 1048, 1051. | |
| 316 | INDIVIDUAL COMPREHENSIVE PSYCHOTHERAPY | 10% | Effective 1-1-10 | Effective 7/1/15, "Discount" would not be applied (100% will be paid) to the following APG rate codes; 1480, 1483, 1486, 1594, 1597, 1122, 1124, 1130, 1132, 1134. Effective 4/1/16, "Discount" would not be applied (100% will be paid) to the following APG rate codes; 1000, 1003, 1060, 1062, 1064, 1066, 1102, 1104, 1106, 1108, 1110, 1112, 1114, 1116, 1118, 1120. Effective 7/1/17, "Discount" would not be applied (100% will be paid) to the following APG rate codes; 1042, 1045, 1048, 1051. | |
| 317 | FAMILY PSYCHOTHERAPY | 10% | Effective 1-1-10 | Effective 7/1/15, "Discount" would not be applied (100% will be paid) to the following APG rate codes; 1480, 1483, 1486, 1594, 1597, 1122, 1124, 1130, 1132, 1134. Effective 4/1/16, "Discount" would not be applied (100% will be paid) to the following APG rate codes; 1000, 1003, 1060, 1062, 1064, 1066, 1102, 1104, 1106, 1108, 1110, 1112, 1114, 1116, 1118, 1120. Effective 7/1/17, "Discount" would not be applied (100% will be paid) to the following APG rate codes; 1042, 1045, 1048, 1051. | |
| 318 | GROUP PSYCHOTHERAPY | 10% | Effective 1-1-10 | Effective 7/1/15, "Discount" would not be applied (100% will be paid) to the following APG rate codes; 1480, 1483, 1486, 1594, 1597, 1122, 1124, 1130, 1132, 1134. Effective 4/1/16, "Discount" would not be applied (100% will be paid) to the following APG rate codes; 1000, 1003, 1060, 1062, 1064, 1066, 1102, 1104, 1106, 1108, 1110, 1112, 1114, 1116, 1118, 1120. Effective 7/1/17, "Discount" would not be applied (100% will be paid) to the following APG rate codes; 1042, 1045, 1048, 1051. | |
| 320 | BEHAVIORAL HEALTH - CASE MANAGEMENT AND TREATMENT PLAN DEVELOPMENT | 10% | Effective 1-1-10 | Effective 7/1/15, "Discount" would not be applied (100% will be paid) to the following APG rate codes; 1480, 1483, 1486, 1594, 1597, 1122, 1124, 1130, 1132, 1134. Effective 4/1/16, "Discount" would not be applied (100% will be paid) to the following APG rate codes; 1000, 1003, 1060, 1062, 1064, 1066, 1102, 1104, 1106, 1108, 1110, 1112, 1114, 1116, 1118, 1120. Effective 7/1/17, "Discount" would not be applied (100% will be paid) to the following APG rate codes; 1042, 1045, 1048, 1051. | |
| 321 | CRISIS INTERVENTION | 10% | Effective 1-1-10 | Effective 7/1/15, "Discount" would not be applied (100% will be paid) to the following APG rate codes; 1480, 1483, 1486, 1594, 1597, 1122, 1124, 1130, 1132, 1134. Effective 4/1/16, "Discount" would not be applied (100% will be paid) to the following APG rate codes; 1000, 1003, 1060, 1062, 1064, 1066, 1102, 1104, 1106, 1108, 1110, 1112, 1114, 1116, 1118, 1120. Effective 7/1/17, "Discount" would not be applied (100% will be paid) to the following APG rate codes; 1042, 1045, 1048, 1051. | |
| 322 | MEDICATION ADMINISTRATION & OBSERVATION | 0% | Changed from 10% to 0% for July 2010. Changed from 0% to 50% for October 2011. Changed from 50% to 0% for July 2012. | ||
| 323 | BEHAVIORAL HEATLH ASSESSMENT | 10% | Effective 1-1-10 | Effective 7/1/15, "Discount" would not be applied (100% will be paid) to the following APG rate codes; 1480, 1483, 1486, 1594, 1597, 1122, 1124, 1130, 1132, 1134. Effective 4/1/16, "Discount" would not be applied (100% will be paid) to the following APG rate codes; 1000, 1003, 1060, 1062, 1064, 1066, 1102, 1104, 1106, 1108, 1110, 1112, 1114, 1116, 1118, 1120. Effective 7/1/17, "Discount" would not be applied (100% will be paid) to the following APG rate codes; 1042, 1045, 1048, 1051. | |
| 324 | SCREENING FOR BEHAVIORAL CHANGE OR RISK ASSESSMENT | 10% | Changed from 0% to 25% Jan 1, 2012. Changed from 25% to 10% July 1, 2012 | Effective 7/1/15, "Discount" would not be applied (100% will be paid) to the following APG rate codes; 1480, 1483, 1486, 1594, 1597, 1122, 1124, 1130, 1132, 1134. Effective 4/1/16, "Discount" would not be applied (100% will be paid) to the following APG rate codes; 1000, 1003, 1060, 1062, 1064, 1066, 1102, 1104, 1106, 1108, 1110, 1112, 1114, 1116, 1118, 1120. Effective 7/1/17, "Discount" would not be applied (100% will be paid) to the following APG rate codes; 1042, 1045, 1048, 1051. | |
| 350 | LEVEL I ADJUNCTIVE GENERAL DENTAL SERVICES | 25% | Effective 7-1-11 | ||
| 351 | LEVEL II ADJUNCTIVE GENERAL DENTAL SERVICES | 25% | Effective 7-1-11 | ||
| 352 | LEVEL I PERIODONTICS | 25% | Effective 7-1-11 | ||
| 353 | LEVEL I PROSTHODONTICS, FIXED | 25% | Effective 7-1-11 | ||
| 354 | LEVEL II PROSTHODONTICS, FIXED | 25% | Effective 7-1-11 | ||
| 355 | LEVEL III PROSTHODONTICS, FIXED | 25% | Effective 7-1-11 | ||
| 356 | LEVEL I PROSTHODONTICS, REMOVABLE | 25% | Effective 7-1-11 | ||
| 357 | LEVEL II PROSTHODONTICS, REMOVABLE | 25% | Effective 7-1-11 | ||
| 358 | LEVEL III PROSTHODONTICS, REMOVABLE | 25% | Effective 7-1-11 | ||
| 359 | LEVEL I MAXILLOFACIAL PROSTHETICS | 25% | Effective 7-1-11 | ||
| 360 | LEVEL II MAXILLOFACIAL PROSTHETICS | 25% | Effective 7-1-11 | ||
| 361 | LEVEL I DENTAL RESTORATIONS | 25% | Effective 7-1-11 | ||
| 362 | LEVEL II DENTAL RESTORATIONS | 25% | Effective 7-1-11 | ||
| 363 | LEVEL III DENTAL RESTORATIONS | 25% | Effective 7-1-11 | ||
| 364 | LEVEL I ENDODONTICS | 25% | Effective 7-1-11 | ||
| 365 | LEVEL II ENDODONTICS | 25% | Effective 7-1-11 | ||
| 366 | LEVEL III ENDODONTICS | 25% | Effective 7-1-11 | ||
| 367 | LEVEL I ORAL AND MAXILLOFACIAL PROCEDURES | 25% | Effective 7-1-11 | ||
| 368 | LEVEL II ORAL AND MAXILLOFACIAL PROCEDURES | 25% | Effective 7-1-11 | ||
| 369 | LEVEL III ORAL AND MAXILLOFACIAL PROCEDURES | 25% | Effective 7-1-11 | ||
| 370 | LEVEL IV ORAL AND MAXILLOFACIAL PROCEDURES | 25% | Effective 7-1-11 | ||
| 372 | SEALANT | 25% | Effective 7-1-11 | ||
| 373 | LEVEL I DENTAL FILM | 25% | Effective 10-1-11 | ||
| 374 | LEVEL II DENTAL FILM | 25% | Effective 10-1-11 | ||
| 377 | PREVENTIVE DENTAL PROCEDURES | 10% | Effective 10-1-11 | ||
| 426 | PSYCHOTROPIC MEDICATION MANAGEMENT | 10% | Effective 4-4-13 | Effective 7/1/15, "Discount" would not be applied (100% will be paid) to the following APG rate codes; 1480, 1483, 1486, 1594, 1597, 1122, 1124, 1130, 1132, 1134. Effective 4/1/16, "Discount" would not be applied (100% will be paid) to the following APG rate codes; 1000, 1003, 1060, 1062, 1064, 1066, 1102, 1104, 1106, 1108, 1110, 1112, 1114, 1116, 1118, 1120. Effective 7/1/17, "Discount" would not be applied (100% will be paid) to the following APG rate codes; 1042, 1045, 1048, 1051. | |
| 493 | LEVEL I ANCILLARY THERAPEUTIC SERVICES | 25% | Effective 7-1-20 | 25% discounting would be applied to only Article 16 APG rate code 1534, 1537, 1546, and 1549. |
