CABHC/PerformCare Alternative Payment Arrangement (APA) Status

CABHC/PerformCare Alternative Payment Arrangement (APA) Status

The CABHC/PerformCare Ambulatory Services APA went into effect March 2020, and currently has no end date.

  • CABHC and PerformCare agreed to extend the Ambulatory APA until 12/31/2021.
  • CABHC and PerformCare plan to discontinue the COVID APA 12/31/2021. If however, the APA continues past January 1, 2022, the APA will be substantially modified. More discussion regarding these plans will be forthcoming.
  • PerformCare will continue to pay provider claims for services that exceed the monthly amount of the APA payment for that service. Claims will continue to show as “zero paid” on EOBs until the APA amount is exceeded for that month, and then subsequent claims will display paid amounts as normal.
  • CABHC and PerformCare will provide at least 45 days’ notice to APA providers prior to ending or modifying the Ambulatory APA.
  • CABHC and PerformCare will engage providers in discussions about the overall functioning of the system before making a decision to terminate or modify the APA.
  • CABHC and PerformCare will monitor provider service delivery levels and may contact providers if service levels do not appear to be trending towards pre-Covid levels of service.
  • If you have any questions, please contact your Account Executive at
    PerformCareProviderRelations@amerihealthcaritas.com

The CABHC/PerformCare Substance Use (SU) Facility APA went into effect March 1, 2020, and is being extended to 12/31/2021.

  • The SU Facility APA includes a 10% rate increase effective 3/1/2020 and will continue at least until 12/31/2021.
  • The SU Facility APA also includes a potential monthly Gap payment to eligible providers, however the SU Facility Gap payment APA for eligible providers was terminated effective 6/30/2021. No gap payments will occur for any months after 6/30/2021.
  • CABHC and PerformCare will provide at least 45 days’ notice to SU Facility APA providers prior to ending or modifying the Substance Use Facility APA.
  • CABHC and PerformCare will engage providers in discussions about the overall functioning of the system before making a decision to terminate or modify the APA.