Alternative Payment Methodology (APM) definition

Alternative Payment Methodology (APM) means a payment mechanism that is at least a partial alternative to fee- for-service (FFS) payments for Track 2 practice sites. APMs shall allow Track 2 practice sites the flexibility to provide comprehensive care outside of the constraints of a billable office visit.
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Examples of Alternative Payment Methodology (APM) in a sentence

  • If EOHHS has approved an Alternative Payment Methodology (APM) for the Contractor, EOHS shall apply an adjustment to the Contractor’s repriced paid claims comparable to the APM adjustment that EOHHS used with respect to the Contractor during Capitation Rate development for the Contract Year.

  • If the Contractor has sub-capitated or Alternative Payment Methodology (APM) arrangements with providers, the sub-capitated or APM payments to providers should be increased by the equivalent of the rate increases that would be required for fee for service payments as set forth in this section.

  • As part of this support, the Contractor shall work with PCMPs to ensure readiness for the Primary Care Alternative Payment Methodology (APM).

  • The full encounter rate shall be at least equal to the Prospective Payment System (PPS) rate specific to each FQHC/RHC and applies to FQHC/RHC reimbursed under the Alternative Payment Methodology (APM) rate methodology and to FQHC/RHC reimbursed under the PPS rate methodology.