Medicaid Fee Schedule without Mods 200801
Medicaid Fee Schedule without Mods 200801
Medicaid Fee Schedule without Mods 200801
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PROC-CODE DESC MAC BEG END<br />
86343 LEUKOCYTE HISTAMINE RELEASE TEST (LHR) $10.45 20060701 99999999<br />
86344 LEUKOCYTE PHAGOCYTOSIS $6.70 20060701 99999999<br />
86353<br />
LYMPHOCYTE TRANSFORMATION, SPONTANEOUS BLASTOGENESIS<br />
OR PHYTOMITOGEN $41.09 20060701 99999999<br />
86355 B CELLS, TOTAL COUNT $36.89 20060701 99999999<br />
86356<br />
MONONUCLEAR CELL ANTIGEN, QUANTITATIVE (EG, FLOW<br />
CYTOMETRY), NOT OTHERWISE SPECI $25.28 <strong>200801</strong>01 99999999<br />
86357 LYMPHOCYTES $31.62 20060701 99999999<br />
86359 T CELLS; TOTAL COUNT $52.13 20060701 99999999<br />
86360 T CELLS; T4 AND T8, INCLUDING RATIO $64.93 20060701 99999999<br />
86361 T CELLS; ABSOLUTE CD4 COUNT $25.00 20060701 99999999<br />
86367 STEM CELLS (IE, CD34), TOTAL COUNT $36.89 20060701 99999999<br />
86376 MICROSOMAL ANTIBODY (THYROID) $20.11 20060701 99999999<br />
86378 MIGRATION INHIBITORY FACTOR TEST (MIF) $16.51 20060701 99999999<br />
86379 NATURAL KILLER (NK) CELLS, TOTAL COUNT $52.70 20050101 99999999<br />
86382 NEUTRALIZATION TEST, VIRAL $14.17 20060701 99999999<br />
86384 NITROBLUE TETRAZOLIUM DYE TEST (NTD) $9.55 20060701 99999999<br />
86403 PARTICLE AGGLUTINATION, RAPID TEST FOR $14.08 20060701 99999999<br />
86406 PARTICLE AGGLUTINATION; TITER, EACH ANTIBODY $14.58 20060701 99999999<br />
86430 RHEUMATOID FACTOR, LATEX FIXATION $7.85 20060701 99999999<br />
86431 RHEUMATOID FACTOR; QUANTITATIVE $7.85 20060701 99999999<br />
86480 SKIN TEST;CAT SCRATCH FEVER $51.95 20060701 99999999<br />
86485 SKIN TEST; CANDIDA $13.04 19990701 99999999<br />
86486 SKIN TEST; UNLISTED ANTIGEN, EACH $3.31 <strong>200801</strong>01 99999999<br />
86490 SKIN TEST $7.69 20060701 99999999<br />
86510 SKIN TEST $8.45 20060701 99999999<br />
86540 SKIN TEST $7.89 19920401 99999999<br />
86580 SKIN TEST $6.68 20060701 99999999<br />
86585 SKIN TEST $6.00 19990701 99999999<br />
86587 SPLITTING OF BLOOD OR BLOOD PRODUCTS, EACH $52.70 20050101 99999999<br />
86590 STREPTOKINASE, ANTIBODY $15.24 20060701 99999999<br />
86592 SYPHILIS TEST $5.90 20060701 99999999<br />
86593 SYPHILIS TEST $6.09 20060701 99999999<br />
86602 ANTIBODY; ACTINOMYCES $8.53 20060701 99999999<br />
86603 ANTIBODY; ADENOVIRUS $10.79 20060701 99999999<br />
86606 ANTIBODY; ASPIRGILLUS $20.80 20060701 99999999<br />
86609 ANTIBODY; BACTERIUM, NOT ELSEWHERE SPECIFIED $17.81 20060701 99999999<br />
86611 ANTIBODY; BARTONELLA $14.22 20060701 99999999<br />
86612 ANTIBODY; BLASTOMYCES $10.82 20060701 99999999<br />
86615 ANTIBODY; BORDETELLA $11.06 20060701 99999999<br />
86617<br />
ANTIBODY; BORRELIA BURGDORFERI (LYME DISEASE)<br />
CONFIRMATORY TEST (EG, WESTERN BLO $21.40 20060701 99999999<br />
86618 ANTIBODY; BORELLIA BUFGDORFERI (LYME DISEASE) $23.54 20060701 99999999<br />
86619 ANTIBODY; BORRELIA (RELAPSING FEVER) $11.21 20060701 99999999<br />
86622 ANTIBODY; BRUCELLA $12.35 20060701 99999999<br />
86625 ANTIBODY; CAMPYLOBACTER $11.00 20060701 99999999<br />
86628 ANTIBODY; CANDIDA $16.60 20060701 99999999<br />
86631 ANTIBODY; CHLAMYDIA $16.35 20060701 99999999<br />
86632 ANTIBODY; CHLAMYDIA, IGM $17.55 20060701 99999999<br />
86635 ANTIBODY; COCCIDIOIDES $9.62 20060701 99999999<br />
86638 ANTIBODY; COXIELLA BRUNETII (Q FEVER) $10.16 20060701 99999999<br />
86641 ANTIBODY; CRYPTOCOCCUS $12.08 20060701 99999999<br />
86644 ANTIBODY; CYTOMEGALOVIRUS (CMV) $19.89 20060701 99999999<br />
86645 ANTIBODY; CYTOMEGALOVIRUS (CMV), IGM $23.28 20060701 99999999<br />
86648 ANTIBODY; DIPTHERIA $21.02 20060701 99999999<br />
86651 ANTIBODY; ENCEPHALITIS, CALIFORNIA (LA CROSSE) $11.06 20060701 99999999<br />
86652 ANTIBODY; ENCEPHALITIS, EASTERN EQUINE $11.06 20060701 99999999<br />
86653 ANTIBODY; ENCEPHALITIS, ST. LOUIS $11.06 20060701 99999999<br />
Hawaii <strong>Medicaid</strong> <strong>Fee</strong> <strong>Schedule</strong> <strong>without</strong> <strong>Mods</strong> 01/2008 257