ADOC is the Abu Dhabi Outpatient Classification, the Department of Health – Abu Dhabi’s casemix classification for outpatient care. It assigns each outpatient service event to one of 113 classes in 5 series and prices the event as a whole, instead of paying each procedure line separately.

Is ADOC mandatory from 1 January 2027?

Yes, for in-scope outpatient care. Shadow billing through Shafafiya began on 1 July 2026 for outpatient providers, insurers and claims management organisations, except dental providers and pharmacies. From 1 January 2027 ADOC becomes the primary reimbursement mechanism for outpatient services in the Emirate of Abu Dhabi.

What is the ADOC M-Series?

The M-Series, Monitoring Diagnostics, is the part of ADOC that pays for certain repeat tests. It prices the first repeat of a test in a recorded monitoring pathway — cancer, transplant and chronic kidney disease, obstetric ultrasound — and every PET scan. The pathway has to be in the treatment plan when the test is ordered.

What are the ADOC follow-up rules?

A return consultation within 7 days for the same class, diagnosis, specialty and facility group is reported at zero value. On day 8–14 most C-Series classes take a ×0.75 adjuster. Patients under 18 or over 60, People of Determination and pregnancy or maternity are exempt, and documented new clinical content breaks the continuation.

What happens to E&M after ADOC?

For in-scope specialist outpatient visits in Abu Dhabi, the C-Series class replaces the E&M level from 1 January 2027. E&M continues outside ADOC — in primary care, emergency care and fee-for-service claims from before the switch — and inside ADOC through the separately identifiable assessment test at procedure visits.

Are diagnostics paid separately under ADOC?

No, with one exception. Imaging and pathology ordered during a visit are reported at zero value and paid inside that visit’s event. The exception is the M-Series: the first repeat in a recorded monitoring pathway, and every PET scan, are priced on their own.

How do I work out an ADOC price?

Take the class’s base price, apply the patient and visit adjusters in the Price List’s order — age, new patient, telemedicine, day 8–14 follow-up, region, Centre of Excellence — then the facility’s series multiplier, and round once. The NANO ADOC page has a calculator that applies every v1.5 adjuster for any of the 113 classes.

What is ADOC? The Abu Dhabi Outpatient Classification, explained

ADOC — the Abu Dhabi Outpatient Classification — is the Department of Health – Abu Dhabi’s casemix classification for outpatient care. It pays each outpatient service event by its class, not by each procedure line. Shadow billing began on 1 July 2026; from 1 January 2027 ADOC is the primary outpatient payment method in the Emirate.

By NANO Health Suite Clinical & Coding Team · Last updated 2026-11-13

What ADOC is, and the ADOC DoH documents

ADOC replaces line-by-line outpatient billing with one classified, priced service event. A visit is assigned to a class, the class carries a base price, adjusters scale it for the patient and the visit, and the facility’s contracted series multiplier is applied last. Diagnostics ordered during the visit are paid inside it rather than as separate lines.

The rules are published by the Department of Health – Abu Dhabi on its Shafafiya prices page (doh.gov.ae/en/Shafafiya/prices) as a set of documents, currently at v1.5: the Definitions Manual, the Counting Rules, the draft Claims & Adjudication Rules, the Price List and the Classification Mapping Tool. They change often, so anything built on them has to treat the rule set as versioned data.

Scope is outpatient care in hospital outpatient departments and clinics, including telemedicine. Inpatient, emergency, day-case, home care and primary care sit outside it, as do dental, renal dialysis, assisted reproduction, drugs, devices and consumables.

The five ADOC series

Classification is top-down: first the series, by the predominant nature of the service, then the class, by the clinician’s specialty or the patient’s condition. ADOC v1.5 has 113 classes.

Series	What it covers	Who bills it	Priced?
P — Interventional Procedures	Seventeen classes: procedures with an incision, anaesthesia beyond local, specialised kit or real-time imaging	Physicians	Yes
C — Specialist Consultations	Fifty-four classes: consultations that contain an E&M service or its equivalent	Physicians	Yes, except family medicine (outside ADOC scope)
S — Support Services	Thirty-one classes: nursing and allied health	Nurses and allied health	Yes, except two classes
D — Diagnostic Services	7 classes: imaging, pathology and clinical measurement	Anyone	No — reported at zero, inside the visit
M — Monitoring Diagnostics	4 classes: the first repeat in a recorded pathway, and every PET scan	Anyone	Yes

The service event: what ADOC counts

A service event is an interaction with clinical content that results in a dated entry in the medical record. Without that entry there is no event to bill, which is why documentation decides revenue under ADOC rather than following it.

One event regardless of how many clinicians took part.
At most one event per series, per patient, per clinician, per calendar day; the highest-priced class is billed and the others are reported at zero value.
Two non-zero classes in the same series on the same day are denied.
Diagnostics are inputs to the visit that ordered them: D-Series lines are zero value, linked to their parent event.
A procedure decided at one visit and carried out at a later one is a continuation at zero value, unless a significant, separately identifiable assessment is documented.

How an ADOC price is built

The Price List’s instructions apply the factors in a fixed order. DoH does not specify rounding; the clean reading is to multiply exactly and round once, at the end. The DoH draft v1.5 prices are for shadow billing only — not for calculating payments — so this guide shows the method, and the calculator shows the numbers.

Base price of the class.
Paediatric adjuster (under 18) or senior adjuster (60 and over), set per class.
New-patient adjuster, up to ×1.40, when the patient had no event in the same class at the same facility in the previous three years.
Telemedicine adjuster: ×0.7 on most C-Series classes, ×1.00 on psychiatry and the S-Series, and no telemedicine route at all for the P-, D- and M-Series.
Day 8–14 follow-up adjuster: ×0.75 on most C-Series classes, unless the patient is exempt.
Region adjuster for Al Ain and Al Dhafra (×1.00 in v1.5) and the quaternary adjuster, ×1.2, at a DoH Centre of Excellence with an eligible diagnosis.
The facility’s series multiplier. During shadow billing DoH’s proxies are the consultation (E&M) multiplier for the C-Series and the procedure (CPT) multiplier for the P- and S-Series; it names no proxy for the M-Series.

Price a visit with the NANO ADOC calculator

ADOC follow-up rules and telemedicine

A return visit within 7 days of the original consultation — same class, diagnosis, specialty and facility group — is a continuation of the first event and is reported at zero value. On day 8–14 most C-Series classes take the ×0.75 adjuster instead.

Both rules are set aside for exempt patients: under 18, over 60, People of Determination and pregnancy or maternity. The Counting Rules add psychiatric consultations by a psychiatrist, wound or burns treatment by a physician, and multidisciplinary case conferences. A visit with documented new clinical content is not a continuation. Note that a patient aged exactly 60 takes the senior adjuster and is still subject to the day 8–14 adjuster.

Telemedicine substitutes for a face-to-face consultation, is initiated by the patient and is for established patients, with exceptions for psychiatry and some Thiqa paediatric and obstetric care.

The ADOC M-Series: when a monitoring repeat is paid

Diagnostics are normally paid inside the visit. The M-Series is the exception, new in v1.5: it prices the first repeat of a test in a monitoring pathway for cancer, transplant and chronic kidney disease, or obstetric ultrasound — but only if the pathway was recorded in the treatment plan when the test was ordered. Every PET scan (M04) is priced.

M-Series diagnostics may still need pre-authorisation under the member’s policy, while other diagnostics ordered within an outpatient event no longer do.

E&M after ADOC

From 1 January 2027, E&M coding is no longer required for outpatient services within ADOC scope: the relevant C-Series class takes its place, so the E&M level stops selecting the price for in-scope specialist visits.

E&M does not disappear. It continues wherever fee-for-service continues, outside ADOC, and inside ADOC one test still turns on it.

Primary care: general practice and family medicine sit outside ADOC and stay on fee-for-service.
Emergency care: emergency attendances sit outside ADOC.
The transition: outpatient claims are fee-for-service until 31 December 2026, and claims first submitted that way are paid at fee-for-service prices even if resubmitted later.
JAWDA data certification: facilities that hold it bill the documented level; others bill the lowest level and report the true one at zero.
The separately identifiable assessment test: a significant, separately identifiable E&M service documented at a procedure visit turns it into a second full consultation.

What to do before 1 January 2027

Model your series multipliers on your own claims before you contract them — one per priced series, per payer.
Shadow-bill every in-scope visit and compare the result with what fee-for-service paid, series by series.
Capture the facts adjusters depend on at the point of care: age, new-patient history, pregnancy, People of Determination status and recorded monitoring pathways.
Close the documentation gaps that make an event zero value: the dated clinical entry, new clinical content in a follow-up and a separately identifiable assessment.
Check encounter types, the master code list and the parent link on every diagnostic line before claims reach Shafafiya.
Payers: re-group claims from their supporting lines and test the follow-up, adjuster and M-Series rules before paying.

Frequently asked questions

What is ADOC?: ADOC is the Abu Dhabi Outpatient Classification, the Department of Health – Abu Dhabi’s casemix classification for outpatient care. It assigns each outpatient service event to one of 113 classes in 5 series and prices the event as a whole, instead of paying each procedure line separately.
Is ADOC mandatory from 1 January 2027?: Yes, for in-scope outpatient care. Shadow billing through Shafafiya began on 1 July 2026 for outpatient providers, insurers and claims management organisations, except dental providers and pharmacies. From 1 January 2027 ADOC becomes the primary reimbursement mechanism for outpatient services in the Emirate of Abu Dhabi.
Where are the ADOC DoH documents published?: On the Department of Health – Abu Dhabi’s Shafafiya prices page. The set is the Definitions Manual, the Counting Rules, the draft Claims & Adjudication Rules, the Price List and the Classification Mapping Tool, currently at v1.5. The prices in it are drafts for shadow billing.
What is the ADOC M-Series?: The M-Series, Monitoring Diagnostics, is the part of ADOC that pays for certain repeat tests. It prices the first repeat of a test in a recorded monitoring pathway — cancer, transplant and chronic kidney disease, obstetric ultrasound — and every PET scan. The pathway has to be in the treatment plan when the test is ordered.
What are the ADOC follow-up rules?: A return consultation within 7 days for the same class, diagnosis, specialty and facility group is reported at zero value. On day 8–14 most C-Series classes take a ×0.75 adjuster. Patients under 18 or over 60, People of Determination and pregnancy or maternity are exempt, and documented new clinical content breaks the continuation.
What happens to E&M after ADOC?: For in-scope specialist outpatient visits in Abu Dhabi, the C-Series class replaces the E&M level from 1 January 2027. E&M continues outside ADOC — in primary care, emergency care and fee-for-service claims from before the switch — and inside ADOC through the separately identifiable assessment test at procedure visits.
Are diagnostics paid separately under ADOC?: No, with one exception. Imaging and pathology ordered during a visit are reported at zero value and paid inside that visit’s event. The exception is the M-Series: the first repeat in a recorded monitoring pathway, and every PET scan, are priced on their own.
How do I work out an ADOC price?: Take the class’s base price, apply the patient and visit adjusters in the Price List’s order — age, new patient, telemedicine, day 8–14 follow-up, region, Centre of Excellence — then the facility’s series multiplier, and round once. The NANO ADOC page has a calculator that applies every v1.5 adjuster for any of the 113 classes.

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