EAPG Reimbursement Effective January 1st, 2020

Date: 11/06/19

Heritage Health (Medicaid):

Effective January 1, 2020, Nebraska Total Care will move to acuity based reimbursement, in line with guidance from Nebraska Medicaid and Long-Term Care, for outpatient hospital services using Enhanced Ambulatory Patient Groups (EAPG) methodology. This updated payment approach will not apply to Critical Access Hospitals (CAH’s).

The base EAPG rates can be viewed on the DHHS website.

Information and training for providers related to EAPG reimbursement will be posted to Provider News and our Provider Training pages.