Medicaid Fee Schedule without Mods 200801

More documents

Recommendations

Info

PROC-CODE DESC MAC BEG END L8619 COCHLEAR IMPLANT EXTERNAL SPEECH PROCESSOR, REPLACEMENT $561.58 20071101 99999999 L8621 DISTAL HUMERUS $0.47 20071101 99999999 L8622 PROXIMAL ULNA/RADIUS $0.25 20071101 99999999 L8623 DISTAL ULNA $48.63 20071101 99999999 L8624 DISTAL RADIUS $121.22 20071101 99999999 L8630 METACARPOPHALANGEAL JOINT $281.81 20071101 99999999 L8631 METACARPAL PHALANGEAL JOINT REPLACEMENT, TWO OR MORE PIECES, METAL (E.G., STAINL $1,653.92 20071101 99999999 L8641 METATARSAL JOINT $292.79 20071101 99999999 L8642 HALLUX IMPLANT $237.49 20071101 99999999 L8658 INTERPHALANGEAL JOINT $255.29 20071101 99999999 L8659 INTERPHALANGEAL FINGER JOINT REPLACEMENT, 2 OR MORE PIECES, METAL (E.G., STAINLE $1,450.65 20071101 99999999 L8670 VASCULAR GRAFT MATERIAL, SYNTHETIC $419.05 20071101 99999999 L8680 BILIARY STENT, ENDOPROSTHESIS (PERMANENT) $349.23 20071101 99999999 L8681 PATIENT PROGRAMMER (EXTERNAL) FOR USE WITH IMPLANTABLE PROGRAMMABLE NEUROSTIMULA $92.36 20071101 99999999 L8682 IMPLANTABLE NEUROSTIMULATOR RADIOFREQUENCY RECEIVER $4,532.45 20071101 99999999 L8683 RADIOFREQUENCY TRANSMITTER (EXTERNAL) FOR USE WITH IMPLANTABLE NEUROSTIMULATOR R $3,989.59 20071101 99999999 L8684 RADIOFREQUENCY TRANSMITTER (EXTERNAL) FOR USE WITH IMPLANTABLE SACRAL ROOT NEURO $569.58 20071101 99999999 L8685 IMPLANTABLE NEUROSTIMULATOR PULSE GENERATOR, SINGLE ARRAY, RECHARGEABLE, INCLUDE $9,941.84 20071101 99999999 L8686 IMPLANTABLE NEUROSTIMULATOR PULSE GENERATOR, SINGLE ARRAY, NON-RECHARGEABLE, INC $6,343.69 20071101 99999999 L8687 IMPLANTABLE NEUROSTIMULATOR PULSE GENERATOR, DUAL ARRAY, RECHARGEABLE, INCLUDES $12,938.31 20071101 99999999 L8688 IMPLANTABLE NEUROSTIMULATOR PULSE GENERATOR, DUAL ARRAY, NON-RECHARGEABLE, INCLU $8,255.68 20071101 99999999 L8689 EXTERNAL RECHARGING SYSTEM FOR IMPLANTED NEUROSTIMULATOR, REPLACEMENT ONLY $1,416.44 20071101 99999999 L8690 AUDITORY OSSEOINTEGRATED DEVICE, INCLUDES ALL INTERNAL AND EXTERNAL COMPONENTS $3,515.70 20071101 99999999 L8691 AUDITORY OSSEOINTEGRATED DEVICE, EXTERNAL SOUND PROCESSOR, REPLACEMENT $1,970.66 20071101 99999999 L8695 EXTERNAL RECHARGING SYSTEM FOR BATTERY (EXTERNAL) FOR USE WITH IMPLANTABLE NEURO $12.53 20071101 99999999 M0005 OFFICE VISITS WITH TWO OR MORE MODALITIES TO THE SAME AREA $21.84 19990701 99999999 M0007 OFFICE VISIT INCLUDING COMBINATION OF ANY MODALITY(S) AND $13.90 19990701 99999999 M0008 OFFICE VISIT INCLUDING COMBINATION OF ANY MODALITY(S) AND $9.20 19990701 99999999 M0064 BRIEF OFFICE VISIT FOR THE SOLE PURPOSE OF MONITORING OR CHANGING DRUG PRESCRIPT $18.84 20060701 99999999 M0101 CUTTING OR REMOVAL OF CORNS,CALLUSES PREVENTIVE $18.80 19990701 99999999 M0302 ASSESSMENT OF CARDIAC OUTPUT BY ELECTRICAL BIOIMPEDANCE $34.41 19990701 99999999 M0585 ACHILLES REFLEX RESPONSE,ELECTRICAL RECORDING (ART) $16.80 19990701 99999999 M0590 MONITORING ECG,EEG,OR PRESSURE IN INTRATHORACTIC OR OTHER CR $92.40 19990701 99999999 M0601 PSYCHOLOGICAL TESTING, WITH WRITTEN REPOR,PER HOUR $56.20 19990701 99999999 M0702 BRIEF,OSTEO MANIP THERAPY NOT IP UP TO 2 BODY REGIONS $25.20 19990701 99999999 M0704 LTD OSTEO MANIP THERAPY NOT IP UP TO 4 BODY REGIONS $25.90 19990701 99999999 M0706 INTERM OSTEO MANIP THERAPY,NOT IP,UP TO 6 BODY REGIONS $87.50 19990701 99999999 M0708 EXT OSTEO MANIP THERAPY,NOT IP, UP TO 8 BODY REGIONS $44.98 19990701 99999999 M0710 COMPR OSTEO MANIP THERAPY,NOT IP, UP TO 10 BODY REGIONS $120.94 19990701 99999999 M0722 BRIEF IP HOSP OMT UP TO 2 BODY REGIONS $36.53 19990701 99999999 M0724 LTD IP HOSP OMT UP TO 4 BODY REGIONS $51.62 19990701 99999999 M0726 INTERM IP HOSP OMT (UP TO SIX BODY REGIONS $99.60 19990701 99999999 Hawaii Medicaid Fee Schedule without Mods 01/2008 76
PROC-CODE DESC MAC BEG END M0728 EXT IP HOSP OMT (UP TO 8 BODY REGIONS) $45.84 19990701 99999999 M0730 COMPR IP HOSP OMT (UP TO 10 BODY REGIONS) $57.64 19990701 99999999 M0900 EXC, REVISION OR REMOVAL OF A-V SHUNT ANASTOMOSIS W/WO GRAFT $281.16 19990701 99999999 M0945 OUTPATIENT DIALYSIS RELATED PHYSIIANS' SERVICES EITHER PROVIDED BY THE PHYSICIA $5.22 19990701 99999999 P2038 MUCOPROTEIN, BLOOD (SEROMUCOID) (MEDICAL NECESSITY PROCEDURE) $6.95 20060701 99999999 P3000 SCREENING PAPANICOLAOU SMEAR, CERVICAL OR VAGINAL, UP TO THREE SMEARS, BY TECHNI $14.60 20060701 99999999 P3001 SCREENING PAPANICOLAOU SMEAR, CERVICAL OR VAGINAL, UP TO THREE SMEARS, REQUIRING $13.75 20060701 99999999 P7001 CULTURE, BACTERIAL, URINE; QUANTITATIVE, SENSITIVITY STUDY $21.60 19990701 99999999 P9010 BLOOD(WHOLE), FOR TRANSFUSION, PER UNIT $94.00 19990701 99999999 P9017 PLASMA, SINGLE DONOR, FRESH FROZEN, EACH UNIT $59.50 19990701 99999999 P9019 PLATELET CONCENTRATE, EACH UNIT $59.50 19990701 99999999 P9021 RED BLOOD CELLS, EACH UNIT $94.00 19990701 99999999 P9022 WASHED RED BLOOD CELLS, EACH UNIT $145.00 19990701 99999999 P9034 PLATELETS, PHERESIS, EACH UNIT $575.00 20010101 99999999 P9035 PLATELETS, PHERESIS, LEUKOCYTES REDUCED, EACH UNIT $580.00 20010101 99999999 P9604 TRAVEL ALLOWANCE 1 WAY IN CONNECT. WITH MEDI.NECES.LAB.SPEC. $2.76 19990701 99999999 P9605 ROUTINE VENIPUNCTURE FOR COLLECTION OF SPECIMEN (S), $5.10 19990701 99999999 P9610 CATHERIZATION FOR COLLECTION OF SPECIMEN (S), $5.10 19990701 99999999 P9612 CATHETERIZATION FOR COLLECTION OF SPECIMEN, SINGLE PATIENT, ALL PLACES OF SERVIC $3.00 20060701 99999999 P9615 CATHERIZATION FOR COLLECTION OF SPECIMEN (S) (MULT.PATIENTS) $3.00 20060701 99999999 Q0035 CARDIOKYMOGRAPHY $24.94 20060701 99999999 Q0068 EXTRACORPOREAL PLASMAPHERESIS: IMMUNOADSORPTION WITH STAPHYLOCOCCAL PROTEIN A CO $103.16 19990701 99999999 Q0069 MAGNETIC RESONANCE (EG., PROTON) IMAGING, BRAIN (INCLUDING BRAIN STEM); WITHOUT $802.47 19990701 99999999 Q0081 INFUSION THERAPY, USING OTHER THAN CHEMOTHERAPEUTIC DRUGS, PER VISIT $30.00 19920101 99999999 Q0083 CHEMOTHERAPY ADMINISTRATION BY OTHER THAN INFUSION TECHNIQUE ONLY (EG SUBCUTANEO $5.00 19920101 99999999 Q0084 CHEMOTHERAPY ADMINISTRATION BY INFUSION TECHNIQUE ONLY, PER VISIT $48.31 19920101 99999999 Q0085 CHEMOTHERAPY ADMINISTRATION BY BOTH INFUSION TECHNIQUE AND OTHER TECHIQUE(S) (EG $48.31 19920101 99999999 Q0091 SCREENING PAPANICOLAOU SMEAR; OBTAINING, PREPARING AND CONVEYANCE OF CERVICAL OR $19.67 20030401 99999999 Q0092 SET-UP PORTABLE X-RAY EQUIPMENT $8.27 20060701 99999999 Q0098 GLUCOSE, BLOOD; BY GLUCOSE MONITOR'G DEVCE CLR'D BY THE FDA SPCFCLLY 4 HOME USE $4.91 19990701 99999999 Q0100 URINALYSIS BY DIP STICK OR TABLET FOR BILIRUBIN, GLUCOSE, HEMOGLOBIN, KETONE $3.97 19990701 99999999 Q0101 MICROHUMATOCRIT, SPUN $3.67 19990701 99999999 Q0102 SEDIMENTATION RATE, ERYTHROCYTE; NON-AUTOMATED $5.51 19990701 99999999 Q0103 PHYSICAL THERAPY EVALUATION, INITIAL $47.77 19990701 99999999 Q0104 PHYSICAL THERAPY RE-EVALUATION, PERIODIC $17.47 19990701 99999999 Q0109 OCCUPATIONAL THERAPY EVALUATION, INITIAL $49.20 19990701 99999999 Q0110 OCCUPATION THERAPY RE-EVALUATION, PERIODIC $17.47 19990701 99999999 Q0111 WET MOUNTS, INCLUDING PREPARATIONS OF VAGINAL, CERVICAL OR SKIN SPECIMENS $5.90 20060701 99999999 Q0112 ALL POTASSIUM HYDROXIDE (KOH) PREPARATIONS $5.90 20060701 99999999 Q0113 PINWORM EXAMINATIONS $7.47 20060701 99999999 Hawaii Medicaid Fee Schedule without Mods 01/2008 77
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: PROC-CODE DESC MAC BEG END L8170 EL
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 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 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 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 127 and 128:
PROC-CODE DESC MAC BEG END 27310 AR
Page 129 and 130:
PROC-CODE DESC MAC BEG END 27513 OP
Page 131 and 132:
PROC-CODE DESC MAC BEG END 27760 TR
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:
PROC-CODE DESC MAC BEG END 29848 AR
Page 139 and 140:
PROC-CODE DESC MAC BEG END 30801 CA
Page 141 and 142:
PROC-CODE DESC MAC BEG END 31560 LA
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:
PROC-CODE DESC MAC BEG END 41114 EX
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:
PROC-CODE DESC MAC BEG END 48511 EX
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:
PROC-CODE DESC MAC BEG END 86788 AN
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?