Medicaid Fee Schedule without Mods 200801

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PROC-CODE DESC MAC BEG END 99345 HOME VISIT FOR THE EVALUATION AND MANAGEMENT OF A NEW PATIENT, WHICH REQUIRES TH $140.70 20060701 99999999 99347 HOME VISIT FOR THE EVALUATION AND MANAGEMENT OF AN ESTABLISHED PATIENT, WHICH RE $35.41 20060701 99999999 99348 HOME VISIT FOR THE EVALUATION AND MANAGEMENT OF AN ESTABLISHED PATIENT, WHICH RE $53.81 20060701 99999999 99349 HOME VISIT FOR THE EVALUATION AND MANAGEMENT OF AN ESTABLISHED PATIENT, WHICH RE $80.79 20060701 99999999 99350 HOME VISIT FOR THE EVALUATION AND MANAGEMENT OF AN ESTABLISHED PATIENT, WHICH RE $116.22 20060701 99999999 99354 PROLONGED PHYSICIAN SERVICE IN THE OFFICE OR OTHER OUTPATIENT SETTING REQUIRING $66.64 20060701 99999999 99355 PROLONGED PHYSICIAN SERVICE IN THE OFFICE OR OTHER OUTPATIENT SETTING REQUIRING $66.34 20060701 99999999 99356 PROLONGED PHYSICIAN SERVICE IN THE INPATIENT SETTING, REQUIRING DIRECT (FACE-TO- $68.89 20060701 99999999 99357 PROLONGED PHYSICIAN SERVICE IN THE INPATIENT SETTING, REQUIRING DIRECT (FACE-TO- $56.45 20060701 99999999 99358 PROLONGED EVALUATION AND MANAGEMENT SERVICE BEFORE AND/OR AFTER DIRECT (FACE-TO- $38.23 19990701 99999999 99381 INITIAL EVALUATION AND MANAGEMENT OF A HEALTHY INDIVIDUAL REQUIRING A COMPREHENS $48.67 19990701 99999999 99382 INITIAL EVALUATION AND MANAGEMENT OF A HEALTHY INDIVIDUAL EARLY CHILDHOOD (AGE 1 $66.86 19990701 99999999 99383 INITIAL EVALUATION AND MANAGEMENT OF A HEALTHY INDIVIDUAL LATE CHILDHOOD (AGE 5 $65.52 19990701 99999999 99384 INITIAL EVALUATION AND MANAGEMENT OF A HEALTHY INDIVIDUAL ADOLESCENT (AGE 12 THR $59.27 19990701 99999999 99385 INITIAL EVALUATION AND MANAGEMENT OF A HEALTHY INDIVIDUAL 18- 39 YEARS $61.58 19990701 99999999 99386 INITIAL EVALUATION AND MANAGEMENT OF A HEALTHY INDIVIDUAL 40- 64 YEARS $59.80 19990701 99999999 99387 INITIAL EVALUATION AND MANAGEMENT OF A HEALTHY INDIVIDUAL 65 YEARS AND OVER $51.38 19990701 99999999 99391 PERIODIC REEVALUATION AND MANAGEMENT OF A HEALTHY INDIVIDUAL REQUIRING A COMPREH $34.35 19990701 99999999 99392 PERIODIC REEVALUATION AND MANAGEMENT OF A HEALTHY INDIVIDUAL EARLY CHILDHOOD (AG $33.27 19990701 99999999 99393 PERIODIC REEVALUATION AND MANAGEMENT OF A HEALTHY INDIVIDUAL LATE CHILDHOOD (AGE $40.89 19990701 99999999 99394 PERIODIC REEVALUATION AND MANAGEMENT OF A HEALTHY INDIVIDUAL ADOLESCENT (AGE 12 $45.94 19990701 99999999 99395 PERIODIC REEVALUATION AND MANAGEMENT OF A HEALTHY INDIVIDUAL 18-39 YEARS $53.86 19990701 99999999 99396 PERIODIC REEVALUATION AND MANAGEMENT OF A HEALTHY INDIVIDUAL 40-64 YEARS $55.27 19990701 99999999 99397 PERIODIC REEVALUATION AND MANAGEMENT OF A HEALTHY INDIVIDUAL 65 YEARS AND OVER $50.97 19990701 99999999 99431 HISTORY AND EXAMINATION OF THE NORMAL NEWBORN INFANT, INITIATION OF DIAGNOSTIC A $58.30 20060701 99999999 99432 NORMAL NEWBORN CARE IN OTHER THAN HOSPITAL OR BIRTHING ROOM SETTING, INCLUDING P $48.69 19990701 99999999 99433 SUBSEQUENT HOSPITAL CARE, FOR THE EVALUATION AND MANAGEMENT OF A NORMAL NEWBORN, $31.16 20060701 99999999 99435 HISTORY AND EXAMINATION OF THE NORMAL NEWBORN INFANT, INCLUDING THE PREPARATION $74.71 20060701 99999999 99436 ATTENDANCE AT DELIVERY (WHEN REQUESTED BY DELIVERING PHYSICIAN) AND INITIAL STAB $47.24 20060701 99999999 Hawaii Medicaid Fee Schedule without Mods 01/2008 294
PROC-CODE DESC MAC BEG END 99440 NEWBORN RESUSCITATION: CARE OF THE HIGH RISK NEWBORN AT DELIVERY, INCLUDING, FOR $92.63 20060701 99999999 99477 INITIAL HOSPITAL CARE, PER DAY, FOR THE EVALUATION AND MANAGEMENT OF THE NEONATE $144.08 20080101 99999999 99499 UNLISTED EVALUATION AND MANAGEMENT SERVICE $32.99 19990701 99999999 99507 HOME VISIT FOR CARE AND MAINTENANCE OF CATHETER(S) (EG, URINARY, DRAINAGE, AND E $5.20 20030401 99999999 99600 INPATIENT ALTERNATIVE CARE $83.20 20030401 99999999 99601 HOME INFUSION/SPECIALTY DRUG ADMINISTRATION, PER VISIT (UP TO 2 HOURS) $16.64 20040101 99999999 Hawaii Medicaid Fee Schedule without Mods 01/2008 295
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