992

REIMBURSEMENT TO FEE-FOR-SERVICE PROVIDERS

FOR SELECTED FREQUENT PROCEDURES

992.1

The Department shall reimburse a fee-for-service provider for the following frequent procedures or services:

Selected Frequent Procedures	Procedure Code	Price
Microbial Identification, Nucleic Acid	87178	$14.18
Initial Medical Visit - DHS	90020 Y4	94.64
Followup Medical Visit - DHS	90060 Y4	94.64
Individual Medical Psychotherapy	90844	37.80
Hemodialysis Procedure w/single	90935	115.20
FRSDC/All Inclusive Dialysis Service	90955 YD	162.00
Echocardiography/realtime w/IMA	93307	112.50
Office Visit, new patient	99205	58.50
Brief Consult/Nurse or non-MD visit	99211 Y4	94.64
Brief Consult/Nurse or non-MD visit	99211 Y5	94.64
Office visit, established patient	99212	18.00
Office visit, established patient	99213	18.00
Office visit, established patient	99214	27.00
Office visit, established patient	99215	40.50
Initial Hospital Care	99221	31.50
Initial Hospital Care	99222	36.00
Initial Hospital Care	99223	40.50
Subsequent Hospital Care, H/P LowCom	99231	16.20
Subsequent Hospital Care	99232	16.20
Subsequent Hospital Care/Day	99233	33.30
Initial Inpatient Consultation	99254	54.00
Emergency Department Visit	99282	17.42
Emergency Department Visit	99283	25.71
Emergency Department Visit	99284	39.13
Critical Care Evaluation and Monitoring	99291	50.40
Periodic Preventive Medicine Re-evaluation	99392	23.40
Community Health Care Clinic visit	99502	68.98
Individual Psychotherapy, Psychiatrist/FSMHC	H5010 Y3	67.50
Individual Psychotherapy, Mental Health Professional	H5015	58.50
Psychotherapy Group	H5020	27.00
Group Therapy (MD or MHP)	H5030	36.00
Comprehensive Evaluation	H5040	180.00
Single VC Service made by Provider	Y2344	17.87
Bifocal VC Serv. made by Provider	Y2345	20.75
Prescription/Medication Assessment.FSMHC	Y3907	31.50

Family Therapy/MHP/FSMHC	Y3908	54.00
Partial Day Programs/Adults	Y5909	105.30
Children's Program	Y6909	108.00
Extended Therapy	Y7909	108.00

SOURCE: Final Rulemaking published at 44 DCR 5495 (September 26, 1997); as amended by Final Rulemaking published at 45 DCR 5224 (August 7, 1998).