Medicaid Fee Schedule without Mods 200801

More documents

Recommendations

Info

PROC-CODE DESC MAC BEG END 71555 MAGNETIC RESONANCE ANGIOGRAPHY, CHEST (EXCLUDING MYOCARDIUM), WITH OR WITHOUT CO $438.68 20060701 99999999 72010 RADIOLOGIC EXAMINATION, SPINE, ENTIRE, SURVEY STUDY, $58.32 20060701 99999999 72020 RADIOLOGIC EXAMINATION, SPINE, SINGLE VIEW, SPECIFY LEVEL $22.39 20060701 99999999 72040 RADIOLOGIC EXAMINATION, SPINE, CERVICAL $32.09 20060701 99999999 72050 RADIOLOGIC EXAMINATION, SPINE, CERVICAL $46.81 20060701 99999999 72052 RADIOLOGIC EXAMINATION, SPINE, CERVICAL $55.95 20060701 99999999 72069 RADIOLOGIC EXAMINATION, SPINE, THORACOLUMBAR, STANDING (SCOLIOSIS) $25.26 20060701 99999999 72070 RADIOLOGIC EXAMINATION, SPINE $33.59 20060701 99999999 72072 RADIOLOGIC EXAMINATION, SPINE $33.24 20060701 99999999 72074 RADIOLOGIC EXAMINATION, SPINE $39.10 20060701 99999999 72080 RADIOLOGIC EXAMINATION, SPINE $32.38 20060701 99999999 72090 RADIOLOGIC EXAMINATION, SPINE $37.71 20060701 99999999 72100 RADIOLOGIC EXAMINATION, SPINE, LUMBOSACRAL $34.48 20060701 99999999 72110 RADIOLOGIC EXAMINATION, SPINE, LUMBOSACRAL $47.49 20060701 99999999 72114 RADIOLOGIC EXAMINATION, SPINE, LUMBOSACRAL $57.07 20060701 99999999 72120 RADIOLOGIC EXAMINATION, SPINE, LUMBOSACRAL, BENDING VIEWS $38.48 20060701 99999999 72125 COMPUTERIZED AXIAL TOMOGRAPHY, CERVICAL SPINE $266.42 20060701 99999999 72126 COMPUTERIZED AXIAL TOMOGRAPHY, CERVICAL SPINE $280.60 20060701 99999999 72127 COMPUTERIZED AXIAL TOMOGRAPHY, CERVICAL SPINE $340.76 20060701 99999999 72128 COMPUTERIZED AXIAL TOMOGRAPHY, THORACIC SPINE $240.34 20060701 99999999 72129 COMPUTERIZED AXIAL TOMOGRAPHY, THORACIC SPINE $280.60 20060701 99999999 72130 COMPUTERIZED AXIAL TOMOGRAPHY, THORACIC SPINE $340.75 20060701 99999999 72131 COMPUTERIZED AXIAL TOMOGRAPHY, LUMBAR SPINE $247.17 20060701 99999999 72132 COMPUTERIZED AXIAL TOMOGRAPHY, LUMBAR SPINE $280.60 20060701 99999999 72133 COMPUTERIZED AXIAL TOMOGRAPHY, LUMBAR SPINE $341.06 20060701 99999999 72141 MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND $431.66 20060701 99999999 72142 MAGNETIC RESONANCE IMAGING,SPINAL CANAL & W/CONT MATERIAL $517.94 20060701 99999999 72146 MRI,SPINAL CANAL & CONTENTS,THORACIC W/O CONTRAST MATERIALS $472.21 20060701 99999999 72147 MRI,SPINAL CONAL & CONTENTS,THORACIC W/CONTRAST MATERIAL(S) $517.94 20060701 99999999 72148 MRI SPINAL CANAL & CONTENTS; W/O CONTRAST LUMBAR $467.81 20060701 99999999 72149 MAGNETIC RESONANCE IMAGING,SPINAL CANAL W/CONTRAST MATERIAL $512.45 20060701 99999999 72156 MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND CONTENTS, WITHOUT CONT $920.36 20060701 99999999 72157 MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND CONTENTS, WITHOUT CONT $920.36 20060701 99999999 72158 MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND CONTENTS, WITHOUT CONT $912.41 20060701 99999999 72170 RADIOLOGIC EXAMINATION, PELVIS $26.78 20060701 99999999 72190 RADIOLOGIC EXAMINATION, PELVIS $34.17 20060701 99999999 72191 COMPUTED TOMOGRAPHIC ANGIOGRAPHY, PELVIS, WITHOUT CONTRAST MATERIAL(S), FOLLOWED $369.74 20060701 99999999 72192 COMPUTERIZED AXIAL TOMOGRAPHY, PELVIS $262.48 20060701 99999999 72193 COMPUTERIZED AXIAL TOMOGRAPHY, PELVIS $278.84 20060701 99999999 72194 COMPUTERIZED AXIAL TOMOGRAPHY, PELVIS $327.07 20060701 99999999 72195 MAGNETIC RESONANCE (EG, PROTON) IMAGING, PELVIS; WITHOUT CONTRAST MATERIAL(S) $373.71 20060701 99999999 72196 MAGNETIC RESONANCE (EG, PROTON) IMAGING, PELVIS $431.66 20060701 99999999 72197 MAGNETIC RESONANCE (EG, PROTON) IMAGING, PELVIS; WITHOUT CONTRAST MATERIAL(S), F $792.67 20060701 99999999 72198 MAGNETIC RESONANCE ANGIOGRAPHY, PELVIS, WITH OR WITHOUT CONTRAST MATERIAL(S) $394.91 20060701 99999999 Hawaii Medicaid Fee Schedule without Mods 01/2008 228
PROC-CODE DESC MAC BEG END 72200 RADIOLOGIC EXAMINATION, SACROILIAC JOINTS $27.12 20060701 99999999 72202 RADIOLOGIC EXAMINATION, SACROILIAC JOINTS $28.90 20060701 99999999 72220 RADIOLOGIC EXAMINATION, SACRUM AND COCCYX, MINIMUM OF TWO $28.81 20060701 99999999 72240 MYELOGRAPHY, CERVICAL $156.47 20060701 99999999 72255 MYELOGRAPHY, THORACIC $178.17 20060701 99999999 72265 MYELOGRAPHY, LUMBOSACRAL $166.71 20060701 99999999 72270 MYELOGRAPHY, ENTIRE SPINAL CANAL $253.11 20060701 99999999 72275 EPIDUROGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION $108.61 20060701 99999999 72285 DISKOGRAPHY, CERVICAL $319.32 20060701 99999999 72295 DISKOGRAPHY, LUMBAR $291.79 20060701 99999999 73000 RADIOLOGIC EXAMINATION $23.36 20060701 99999999 73010 RADIOLOGIC EXAMINATION $27.12 20060701 99999999 73020 RADIOLOGIC EXAMINATION, SHOULDER $23.44 20060701 99999999 73030 RADIOLOGIC EXAMINATION, SHOULDER $28.13 20060701 99999999 73040 RADIOLOGIC EXAMINATION, SHOULDER, ARTHROGRAPHY $90.51 20060701 99999999 73050 RADIOLOGIC EXAMINATION $33.51 20060701 99999999 73060 RADIOLOGIC EXAMINATION $28.39 20060701 99999999 73070 RADIOLOGIC EXAMINATION, ELBOW $23.75 20060701 99999999 73080 RADIOLOGIC EXAMINATION, ELBOW $25.75 20060701 99999999 73085 RADIOLOGIC EXAMINATION, ELBOW, ARTHROGRAPHY $90.82 20060701 99999999 73090 RADIOLOGIC EXAMINATION $26.47 20060701 99999999 73092 RADIOLOGIC EXAMINATION $22.74 20060701 99999999 73100 RADIOLOGIC EXAMINATION, WRIST $25.44 20060701 99999999 73110 RADIOLOGIC EXAMINATION, WRIST $24.25 20060701 99999999 73115 RADIOLOGIC EXAMINATION, WRIST, ARTHROGRAPHY $73.79 20060701 99999999 73120 RADIOLOGIC EXAMINATION, HAND $28.24 20060701 99999999 73130 RADIOLOGIC EXAMINATION, HAND $27.34 20060701 99999999 73140 RADIOLOGIC EXAMINATION, FINGER OR FINGERS, MINIMUM OF TWO $21.42 20060701 99999999 73200 COMPUTERIZED AXIAL TOMOGRAPHY, UPPER EXTREMITY $205.80 20060701 99999999 73201 COMPUTERIZED AXIAL TOMOGRAPHY, UPPER EXTREMITY $240.34 20060701 99999999 73202 COMPUTERIZED AXIAL TOMOGRAPHY, UPPER EXTREMITY $356.88 20060701 99999999 73206 COMPUTED TOMOGRAPHIC ANGIOGRAPHY, UPPER EXTREMITY, WITHOUT CONTRAST MATERIAL(S), $342.45 20060701 99999999 73218 MAGNETIC RESONANCE (EG, PROTON) IMAGING, UPPER EXTREMITY, OTHER THAN JOINT; WITH $368.37 20060701 99999999 73219 MAGNETIC RESONANCE (EG, PROTON) IMAGING, UPPER EXTREMITY, OTHER THAN JOINT; WITH $442.17 20060701 99999999 73220 MAGNETIC RESONANCE (EG, PROTON) IMAGING, UPPER EXTREMITY, $714.47 20060701 99999999 73221 MAGNETIC RESONANCE (EG, PROTON) IMAGING, ANY JOINT OF UPPER EXTREMITY $423.20 20060701 99999999 73222 MAGNETIC RESONANCE (EG, PROTON) IMAGING, ANY JOINT OF UPPER EXTREMITY; WITH CONT $442.17 20060701 99999999 73223 MAGNETIC RESONANCE (EG, PROTON) IMAGING, ANY JOINT OF UPPER EXTREMITY; WITHOUT C $787.12 20060701 99999999 73500 RADIOLOGIC EXAMINATION, HIP $25.41 20060701 99999999 73510 RADIOLOGIC EXAMINATION, HIP $30.75 20060701 99999999 73520 RADIOLOGIC EXAMINATION, HIPS, BILATERAL, MINIMUM OF TWO VIEWS $36.74 20060701 99999999 73525 RADIOLOGIC EXAMINATION, HIP, ARTHROGRAPHY $92.67 20060701 99999999 73530 RADIOLOGIC EXAMINATION, HIP, DURING OPERATIVE PROCEDURE $28.35 20060701 99999999 73540 RADIOLOGIC EXAMINATION, PELVIS AND HIPS, INFANT OR CHILD, $27.17 20060701 99999999 73542 RADIOLOGICAL EXAMINATION, SACROILIAC JOINT ARTHROGRAPHY, RADIOLOGICAL SUPERVISIO $88.21 20060701 99999999 73550 RADIOLOGIC EXAMINATION, FEMUR, ANTEROPOSTERIOR $25.75 20060701 99999999 73560 RADIOLOGIC EXAMINATION, KNEE $23.94 20060701 99999999 73562 RADIOLOGIC EXAMINATION, KNEE $29.46 20060701 99999999 Hawaii Medicaid Fee Schedule without Mods 01/2008 229
Page 1 and 2:
PROC-CODE DESC MAC BEG END A0130 NO
Page 3 and 4:
PROC-CODE DESC MAC BEG END A4355 3-
Page 5 and 6:
PROC-CODE DESC MAC BEG END A4431 OS
Page 7 and 8:
PROC-CODE DESC MAC BEG END A5093 OS
Page 9 and 10:
PROC-CODE DESC MAC BEG END A6231 GA
Page 11 and 12:
PROC-CODE DESC MAC BEG END A6452 HI
Page 13 and 14:
PROC-CODE DESC MAC BEG END A7504 FI
Page 15 and 16:
PROC-CODE DESC MAC BEG END ENTERAL
Page 17 and 18:
PROC-CODE DESC MAC BEG END D4210 GI
Page 19 and 20:
PROC-CODE DESC MAC BEG END D7911 SU
Page 21 and 22:
PROC-CODE DESC MAC BEG END E0248 TR
Page 23 and 24:
PROC-CODE DESC MAC BEG END E0580 NE
Page 25 and 26:
PROC-CODE DESC MAC BEG END E0911 TR
Page 27 and 28:
PROC-CODE DESC MAC BEG END E1085 HE
Page 29 and 30:
PROC-CODE DESC MAC BEG END E1638 HE
Page 31 and 32:
PROC-CODE DESC MAC BEG END E2324 PO
Page 33 and 34:
PROC-CODE DESC MAC BEG END E2605 PO
Page 35 and 36:
PROC-CODE DESC MAC BEG END G0091 IN
Page 37 and 38:
PROC-CODE DESC MAC BEG END G0206 DI
Page 39 and 40:
PROC-CODE DESC MAC BEG END K0032 SE
Page 41 and 42:
PROC-CODE DESC MAC BEG END K0130 FO
Page 43 and 44:
PROC-CODE DESC MAC BEG END K0240 HY
Page 45 and 46:
PROC-CODE DESC MAC BEG END K0529 ST
Page 47 and 48:
PROC-CODE DESC MAC BEG END K0822 PO
Page 49 and 50:
PROC-CODE DESC MAC BEG END L0350 TL
Page 51 and 52:
PROC-CODE DESC MAC BEG END L0633 LU
Page 53 and 54:
PROC-CODE DESC MAC BEG END L1685 HO
Page 55 and 56:
PROC-CODE DESC MAC BEG END L2106 AF
Page 57 and 58:
PROC-CODE DESC MAC BEG END L2670 AD
Page 59 and 60:
PROC-CODE DESC MAC BEG END L3420 FU
Page 61 and 62:
PROC-CODE DESC MAC BEG END L3906 WH
Page 63 and 64:
PROC-CODE DESC MAC BEG END L4110 RE
Page 65 and 66:
PROC-CODE DESC MAC BEG END L5622 AD
Page 67 and 68:
PROC-CODE DESC MAC BEG END L5701 AL
Page 69 and 70:
PROC-CODE DESC MAC BEG END L5981 AL
Page 71 and 72:
PROC-CODE DESC MAC BEG END L6646 UP
Page 73 and 74:
PROC-CODE DESC MAC BEG END L6915 HA
Page 75 and 76:
PROC-CODE DESC MAC BEG END L8170 EL
Page 77 and 78:
PROC-CODE DESC MAC BEG END M0728 EX
Page 79 and 80:
PROC-CODE DESC MAC BEG END Q4047 CA
Page 81 and 82:
PROC-CODE DESC MAC BEG END V2522 CO
Page 83 and 84:
PROC-CODE DESC MAC BEG END W9801 QU
Page 85 and 86:
PROC-CODE DESC MAC BEG END 00530 AN
Page 87 and 88:
Page 89 and 90:
Page 91 and 92:
Page 93 and 94:
Page 95 and 96:
PROC-CODE DESC MAC BEG END 11443 EX
Page 97 and 98:
PROC-CODE DESC MAC BEG END 12056 LA
Page 99 and 100:
PROC-CODE DESC MAC BEG END 15341 TI
Page 101 and 102:
Page 103 and 104:
PROC-CODE DESC MAC BEG END 19110 NI
Page 105 and 106:
PROC-CODE DESC MAC BEG END 20612 AS
Page 107 and 108:
PROC-CODE DESC MAC BEG END 21100 AP
Page 109 and 110:
PROC-CODE DESC MAC BEG END 21310 TR
Page 111 and 112:
PROC-CODE DESC MAC BEG END 21920 BI
Page 113 and 114:
PROC-CODE DESC MAC BEG END 22844 PO
Page 115 and 116:
Page 117 and 118:
Page 119 and 120:
PROC-CODE DESC MAC BEG END 25316 FL
Page 121 and 122:
PROC-CODE DESC MAC BEG END 26010 DR
Page 123 and 124:
PROC-CODE DESC MAC BEG END 26530 AR
Page 125 and 126:
Page 127 and 128:
Page 129 and 130:
PROC-CODE DESC MAC BEG END 27513 OP
Page 131 and 132:
Page 133 and 134:
PROC-CODE DESC MAC BEG END 28200 RE
Page 135 and 136:
PROC-CODE DESC MAC BEG END 28636 PE
Page 137 and 138:
Page 139 and 140:
PROC-CODE DESC MAC BEG END 30801 CA
Page 141 and 142:
Page 143 and 144:
PROC-CODE DESC MAC BEG END 32310 PL
Page 145 and 146:
Page 147 and 148:
Page 149 and 150:
Page 151 and 152:
Page 153 and 154:
PROC-CODE DESC MAC BEG END 35102 DI
Page 155 and 156:
PROC-CODE DESC MAC BEG END TRANSLUM
Page 157 and 158:
Page 159 and 160:
PROC-CODE DESC MAC BEG END 36555 IN
Page 161 and 162:
PROC-CODE DESC MAC BEG END 37188 PE
Page 163 and 164:
Page 165 and 166:
Page 167 and 168:
PROC-CODE DESC MAC BEG END 42836 AD
Page 169 and 170:
PROC-CODE DESC MAC BEG END 43260 EN
Page 171 and 172:
Page 173 and 174:
Page 175 and 176:
PROC-CODE DESC MAC BEG END 45114 PR
Page 177 and 178: PROC-CODE DESC MAC BEG END 46221 HE
Page 179 and 180: PROC-CODE DESC MAC BEG END 47370 LA
Page 181 and 182: PROC-CODE DESC MAC BEG END 48511 EX
Page 183 and 184: PROC-CODE DESC MAC BEG END 49495 RE
Page 185 and 186: PROC-CODE DESC MAC BEG END 50393 IN
Page 187 and 188: PROC-CODE DESC MAC BEG END 50940 DE
Page 189 and 190: PROC-CODE DESC MAC BEG END 51920 CL
Page 191 and 192: PROC-CODE DESC MAC BEG END 52647 NO
Page 193 and 194: PROC-CODE DESC MAC BEG END 54162 LY
Page 195 and 196: PROC-CODE DESC MAC BEG END 55110 SC
Page 197 and 198: PROC-CODE DESC MAC BEG END 56353 HY
Page 199 and 200: PROC-CODE DESC MAC BEG END 57310 CL
Page 203 and 204: PROC-CODE DESC MAC BEG END 59070 TR
Page 205 and 206: PROC-CODE DESC MAC BEG END 61026 VE
Page 207 and 208: PROC-CODE DESC MAC BEG END 61576 TR
Page 209 and 210: PROC-CODE DESC MAC BEG END 61865 CR
Page 211 and 212: PROC-CODE DESC MAC BEG END 62360 IM
Page 217 and 218: PROC-CODE DESC MAC BEG END 64837 SU
Page 219 and 220: PROC-CODE DESC MAC BEG END 65870 SE
Page 221 and 222: PROC-CODE DESC MAC BEG END 67225 DE
Page 223 and 224: PROC-CODE DESC MAC BEG END 68320 CO
Page 225 and 226: PROC-CODE DESC MAC BEG END 69643 TY
Page 227: PROC-CODE DESC MAC BEG END 70542 MA
Page 231 and 232: PROC-CODE DESC MAC BEG END 74246 RA
Page 233 and 234: PROC-CODE DESC MAC BEG END 75822 VE
Page 237 and 238: PROC-CODE DESC MAC BEG END 76938 UL
Page 241 and 242: PROC-CODE DESC MAC BEG END 78261 GA
Page 245 and 246: PROC-CODE DESC MAC BEG END 82000 AC
Page 247 and 248: PROC-CODE DESC MAC BEG END 82533 CO
Page 249 and 250: PROC-CODE DESC MAC BEG END 83015 HE
Page 251 and 252: PROC-CODE DESC MAC BEG END 83903 MO
Page 253 and 254: PROC-CODE DESC MAC BEG END 84425 TH
Page 255 and 256: PROC-CODE DESC MAC BEG END 85370 FI
Page 257 and 258: PROC-CODE DESC MAC BEG END 86343 LE
Page 259 and 260: PROC-CODE DESC MAC BEG END 86788 AN
Page 261 and 262: PROC-CODE DESC MAC BEG END 87206 SM
Page 267 and 268: PROC-CODE DESC MAC BEG END 88184 FL
Page 269 and 270: PROC-CODE DESC MAC BEG END 89140 GA
Page 271 and 272: PROC-CODE DESC MAC BEG END 90734 ME
Page 273 and 274: PROC-CODE DESC MAC BEG END 90847 FA
Page 275 and 276: PROC-CODE DESC MAC BEG END 92250 OP
Page 277 and 278: PROC-CODE DESC MAC BEG END 92602 DI
Page 279 and 280:
PROC-CODE DESC MAC BEG END 93237 EL
Page 281 and 282:
PROC-CODE DESC MAC BEG END 93650 IN
Page 283 and 284:
PROC-CODE DESC MAC BEG END 94016 PA
Page 285 and 286:
PROC-CODE DESC MAC BEG END 95811 PO
Page 287 and 288:
PROC-CODE DESC MAC BEG END 96000 CO
Page 289 and 290:
PROC-CODE DESC MAC BEG END 97022 PH
Page 291 and 292:
PROC-CODE DESC MAC BEG END 99214 OF
Page 293 and 294:
PROC-CODE DESC MAC BEG END 99307 SU
Page 295:
PROC-CODE DESC MAC BEG END 99440 NE
show all

Medicaid Fee Schedule without Mods 200801

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?