WebNov 3, 2024 · methodology using Ohio Department of Medicaid (ODM) billing guidelines. CareSource began processing claims using the EAPG methodology for dates of service on or after Oct. 1, 2024. The EAPG billing methodology will supersede any prior CareSource payment policies. Example

Frequently Asked Enhanced Ambulatory Patient Grouping …

WebApply Online Using CommonHelp. There are several Medical Assistance Programs offered in Virginia. Each program covers different groups of people and each program has … WebExisting Medicaid outpatient rate methodologies are broken, most payments are capped and ambulatory surgery rates are outdated. ... Medical EAPG and significant procedure EAPG allowed on same day with modifier 25 (new to version 3.) Modifier 25 must be coded on medical visit indicator code (E&M CPT code) Multiple medical visits on same day dynaudio core subwoofer

Modifiers Recognized by Ohio Medicaid

WebGrouping - modifiers Ignore all modifiers: No Use modifier -25: Yes Use modifier -27: Yes Use modifier -59: Yes Use therapy modifiers -GN, -GO and -GP: No Use anatomical or select modifiers: No Use never event modifiers, -PA, -PB, -PC: No Use modifier -57: No Use Distinct Procedure Modifier: Yes Use modifier -JW: No Use distinct medical … WebPatients in each EAPG have similar clinical characteristics, resource use and cost. Q: What do EAPGs encompass? ... Ohio Department of Medicaid as described in . OAC 5160-2 … WebOct 1, 2024 · The modifiers used with EAPGs vary depending on the payer’s choice. ... DC Medicaid EAPG Information October 1, 2024 6 Control Log No.: DCO22024 EAPGs to calculate payment. The EAPG software is customized for the payer to perform either the grouping or the pricing or both. csat performance review