October 23, 2019
Differential Adjusted Payment (DAP)

Ap plicable to: Mercy Care Complete Care, Mercy Care RBHA, Mercy Care Long Term Care and Division of Developmental Disabilities 
DAP rates are proposed to be implemented in order to assure that payments are consistent with efficiency, economy, and quality of care and are sufficient to enlist enough providers so that care and services are available at least to the extent that such care and services are available to the general population in the geographic area. AHCCCS will implement DAP rates for select AHCCCS registered providers, which meet Agency established performance criteria for the following providers: 
  1. Hospitals Subject to APR-DRG Reimbursement
  2. Other Hospitals and Inpatient Facilities
  3. Indian Health Services (IHS) and 638 Tribally Owned and/or Operated Facilities
  4. Nursing Facilities
  5. Integrated Clinics
  6. Behavioral Health Outpatient Clinics
  7. Physicians, Physician Assistants, and Registered Nurse Practitioners
  8. Dental Providers
  9. Home and Community Based Service Providers

The DAP rates currently in place expire after the September 30, 2019 date of service. The DAP rates in this notice for CYE 2020 will be effective with dates of service beginning October 1, 2019, through September 30, 2020, and all noted providers (based on distinct Provider Types) will have the opportunity to be considered for meeting the criteria described further below. 

The DAP Schedule represents a positive adjustment to the AHCCCS Fee-For-Service (FFS) rates. The purpose of the DAP is to distinguish providers which have committed to supporting designated actions that improve patients' care experience, improve members' health, and reduce cost of care growth. These fee schedules will be limited to dates of service in CYE 2020. AHCCCS managed care organizations (MCOs; including Regional Behavioral Health Authorities - RBHAs) will be required to pass-through DAP increases to their contracted providers, maintaining rates to match the corresponding AHCCS FFS rate increase percentages. 

For further information regarding the  Differential Adjusted Payment (DAP), please click on the link. 

As always, don't hesitate to contact your Mercy Care Provider Relations Representative with any questions or comments. You can find this notice and all other provider notices on our Mercy Care website.

We appreciate your continued assistance, support and cooperation!