Medicaid Fee Schedule without Mods 200801

More documents

Recommendations

Info

PROC-CODE DESC MAC BEG END E0434 PORTABLE LIQUID OXYGEN SYSTEM, RENTAL; INCLUDES PORTABLE CONTAINER, SUPPLY RESER $32.08 20050101 99999999 E0439 STATIONARY LIQUID OXYGEN SYSTEM, RENTAL; INCLUDES USE OF RESERVOIR, CONTENTS (PE $200.39 20050101 99999999 E0440 OXYGEN SYSTEM, LIQUID, STATIONARY, INCLUDES USE OF RESERVOIR, $329.68 20030401 99999999 E0441 OXYGEN CONTENTS, GASEOUS, PER UNIT (FOR USE WITH OWNED GASEOUS STATIONARY SYSTEM $198.12 20060701 99999999 E0442 OXYGEN CONTENTS, LIQUID, PER UNIT (FOR USE WITH OWNED LIQUID STATIONARY SYSTEMS $198.12 20060701 99999999 E0443 PORTABLE OXYGEN CONTENTS, GASEOUS, PER UNIT (FOR USE ONLY WITH PORTABLE GASEOUS $44.36 20060701 99999999 E0444 PORTABLE OXYGEN CONTENTS, LIQUID, PER UNIT (FOR USE ONLY WITH PORTABLE LIQUID SY $44.36 20060701 99999999 E0445 OXYGEN TENT; EXC CROUP OR PEDIATRIC TENTS $320.00 19990701 99999999 E0452 INTERMITTENT ASSIST DEVICE WITH CONTINUOUS POSITIVE AIRWAY PRESSURE DEVICE (CPAP $1,456.00 20030401 99999999 E0454 PRESSURE VENTILATOR WITH PRESSURE CONTROL, PRESSURE SUPPORT AND FLOW TRIGGERING $1,400.14 20030101 99999999 E0455 OXYGEN TENT,EXCL CROUP OR PEDIATRIC TENTS $20.00 20071101 99999999 E0457 CHEST SHELL(CUIRASS) $614.51 20030401 99999999 E0459 CHEST WRAP $93.68 20071101 99999999 E0460 NEGATIVE PRESSURE VENTILATOR;PORTABLE(EG.PORTA-LUNG) $704.83 20071101 99999999 E0470 RESPIRATORY ASSIST DEVICE, BI-LEVEL PRESSURE CAPABILITY, WITHOUT BACKUP RATE FEA $2,660.50 20040101 99999999 E0471 RESPIRATORY ASSIST DEVICE, BI-LEVEL PRESSURE CAPABILITY, WITH BACK-UP RATE FEATU $253.77 20040101 99999999 E0472 RESPIRATORY ASSIST DEVICE, BI-LEVEL PRESSURE CAPABILITY, WITH BACKUP RATE FEATUR $673.77 20040101 99999999 E0483 HIGH FREQUENCY CHEST WALL OSCILLATION AIR-PULSE GENERATOR SYSTEM, (INCLUDES HOSE $1,063.13 20030101 99999999 E0484 OSCILLATORY POSITIVE EXPIRATORY PRESSURE DEVICE, NON- ELECTRIC, ANY TYPE, EACH $36.92 20030401 99999999 E0485 ORAL DEVICE/APPLIANCE USED TO REDUCE UPPER AIRWAY COLLAPSIBILITY, ADJUSTABLE OR $5.00 20071101 99999999 E0486 ORAL DEVICE/APPLIANCE USED TO REDUCE UPPER AIRWAY COLLAPSIBILITY, ADJUSTABLE OR $5.00 20071101 99999999 E0500 IPPB W/MANUAL VALVES EXT POWER SOURCE,INCL CYLINDER REG,NEBU $1,134.64 20030401 99999999 E0550 HUMIDIFIER,DURABLE FOR EXT SUPPLEMENTAL HUMIDIFICATION W/IPP $143.52 20030401 99999999 E0555 HUMIDIFIER, DURABLE, GLASS OR AUTOCLAVABLE PLASTIC BOTTLE $5.00 19990701 99999999 E0560 HUMIDIFIER, DURABLE FOR SUPPLEMENTAL HUMIDIFICATION DURING $129.17 20030401 99999999 E0561 HUMIDIFIER, NON-HEATED, USED WITH POSITIVE AIRWAY PRESSURE DEVICE $10.32 20040101 99999999 E0562 HUMIDIFIER, HEATED, USED WITH POSITIVE AIRWAY PRESSURE DEVICE $28.72 20040101 99999999 E0565 COMPRESSOR, AIR POWER SOURCE FOR EQUIPMENT WHICH IS NOT SELF- $75.90 20071101 99999999 E0570 NEBULIZER, WITH COMPRESSOR E.G., DEVILBISS PULMO-AID $13.00 20071101 99999999 E0571 AEROSOL COMPRESSOR, BATTERY POWERED, FOR USE WITH SMALL VOLUME NEBULIZER $28.37 20071101 99999999 E0572 AEROSOL COMPRESSOR, ADJUSTABLE PRESSURE, LIGHT DUTY FOR INTERMITTENT USE $36.03 20071101 99999999 E0574 ULTRASONIC GENERATOR WITH SMALL VOLUME ULTRASONIC NEBULIZER $38.09 20071101 99999999 E0575 NEBULIZER, SELF-CONTAINED, ULTRASONIC $13.00 20071101 99999999 Hawaii Medicaid Fee Schedule without Mods 01/2008 22
PROC-CODE DESC MAC BEG END E0580 NEBULIZER,DURABLE,GLASS OR AUTOCLAVABLE,BOTTLE TYPE,FOR USE $134.04 20030401 99999999 E0585 NEBULIZER,W/COMPRESSOR AND HEATER $57.96 20071101 99999999 E0600 SUCTION PUMP, HOME MODEL, PORTABLE $44.79 20071101 99999999 E0601 NASAL CONTINUOUS AIRWAY PRESSURE(CPAP)DEVICE $1,182.48 20030401 99999999 E0602 BREAST PUMP, ALL TYPES $29.52 20030401 99999999 E0605 VAPORIZER, ROOM TYPE $75.56 20030401 99999999 E0606 POSTURAL DRAINAGE BOARD $228.80 20030401 99999999 E0607 HOME BLOOD GLUCOSE MONITOR $73.51 20030401 99999999 E0608 APNEA MONITOR $239.20 20030401 99999999 E0609 BLOOD GLUCOSE MONITOR W/SPECIAL FEATURES(EG.VOICE SYNTH ECT) $504.96 20030401 99999999 E0610 PACEMAKER MONITOR,SELF CONT,(CHECKS BATTERY DEPLETION,INCL $499.30 20030401 99999999 E0615 PACEMAKER MONITOR,SELF CHECKS BATTERY DELPETION AND OTHER $486.71 20030401 99999999 E0616 IMPLANTABLE CARDIAC EVENT RECORDER WITH MEMORY, ACTIVATOR AND PROGRAMMER $500.00 20071101 99999999 E0617 EXTERNAL DEFIBRILLATOR WITH INTEGRATED ELECTROCARDIOGRAM ANALYSIS $304.05 20071101 99999999 E0618 APNEA MONITOR, WITHOUT RECORDING FEATURE $85.00 20030401 99999999 E0620 SEAT LIFT CHAIR, MOTORIZED TO ASSIST PATIENT IN STANDING AND SITTING $0.05 20071101 99999999 E0621 SLING OR SEAT, PATIENT LIFT, CANVAS OR NYLON $97.00 20071101 99999999 E0625 PATIENT LIFT,KARTOP,BATHROOM OR TOILET $100.00 20071101 99999999 E0627 SEAT LIFT MECHANISM INCORPORATED INTO A COMBINATION LIFT- CHAIR MECHANISM $357.15 20071101 99999999 E0628 SEPARATE SEAT LIFT MECHANISM FOR USE WITH PATIENT OWNED FURNITURE-ELECTRIC $357.15 20071101 99999999 E0629 SEPARATE SEAT LIFT MECHANISM FOR USE WITH PATIENT OWNED FURNITURE-NON-ELECTRIC $357.15 20071101 99999999 E0630 PATIENT LIFT,HYDRAULIC, W/SEAT OR SLING $1,303.12 20030401 99999999 E0635 PATIENT LIFT,ELECTRIC W/SEAT OR SLING $142.55 20071101 99999999 E0636 MULTIPOSITIONAL PATIENT SUPPORT SYSTEM, WITH INTEGRATED LIFT, PATIENT ACCESSIBLE $1,054.56 20071101 99999999 E0650 PNEUMATIC COMPRESSOR, NON-SEGMENTAL HOME MODEL, $107.55 20071101 99999999 E0651 PNEUMATIC COMPRESSOR,SEGMENTAL HOME MODEL W/O CALIBRATED GRA $666.57 20030401 99999999 E0652 PNEUMATIC COMPRESSOR SEGMENTAL HOME MODEL W/CALIBRATED GRADI $6,600.54 20030401 99999999 E0655 PNEUMATIC APPLIANCE FOR USE W/PNEUMATIC COMPRESSOR HALF ARM $96.95 20030401 99999999 E0660 PNEUMATIC APPLIANCE FOR USE W/PNEUMATIC COMPRESSOR,FULL LEG $119.16 20030401 99999999 E0665 PNEUMATIC APPLIANCE FOR USE W PNEUMATIC COMPRESSOR,FULL ARM $111.44 20030401 99999999 E0666 PNEUMATIC APPLIANCE FOR USE W/PNEUMATIC COMPRESSOR,HALF LEG $94.79 20030401 99999999 E0667 PNEUMATIC APPLIANCE FOR USE W/SEGMENTAL PNEUMATIC COMPRESSOR $553.95 20030401 99999999 E0668 PNEUMATIC APPLIANCE FOR USE W/SEGMENTAL PNEUMATIC COMPRESSOR $474.25 20030401 99999999 E0669 SEGMENTAL PNEUMATIC APPLIANCE FOR USE WITH PNEUMATIC COMPRESSOR, HALF LEG $198.00 20030401 99999999 E0671 SEGMENTAL GRADIENT PRESSURE PNEUMATIC APPLIANCE, FULL LEG $448.57 20030401 99999999 SEGMENTAL GRADIENT PRESSURE PNEUMATIC APPLIANCE, FULL E0672 ARM $348.56 20030401 99999999 Hawaii Medicaid Fee Schedule without Mods 01/2008 23
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: PROC-CODE DESC MAC BEG END E0248 TR
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:
Page 181 and 182:
Page 183 and 184:
Page 185 and 186:
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 201 and 202:
Page 203 and 204:
Page 205 and 206:
PROC-CODE DESC MAC BEG END 61026 VE
Page 207 and 208:
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 213 and 214:
Page 215 and 216:
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 and 228:
PROC-CODE DESC MAC BEG END 70542 MA
Page 229 and 230:
PROC-CODE DESC MAC BEG END 72200 RA
Page 231 and 232:
Page 233 and 234:
PROC-CODE DESC MAC BEG END 75822 VE
Page 235 and 236:
Page 237 and 238:
PROC-CODE DESC MAC BEG END 76938 UL
Page 239 and 240:
Page 241 and 242:
PROC-CODE DESC MAC BEG END 78261 GA
Page 243 and 244:
Page 245 and 246:
PROC-CODE DESC MAC BEG END 82000 AC
Page 247 and 248:
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:
Page 261 and 262:
PROC-CODE DESC MAC BEG END 87206 SM
Page 263 and 264:
Page 265 and 266:
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:
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:
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?