APPENDIX A – April 1, 1999 Changes

NEW FEE SCHEDULE CODES

Location Code Description Fee
GENERAL PREAMBLE C988B Special Visit to Assist at Non-Elective Surgery With Sacrifice of Hours

$ 33.90

CONSULTATIONS & VISITS A902 Housecall Assessment –Pronouncement of Death in the Home

$ 38.80

  K191 Family Psychiatric care, in-patient per ½ hour or major part thereof

$ 58.45

  K196 Family Psychiatric care, out-patient per ½ hour or major part thereof

$ 58.45

  K199 Psychiatric care, out-patient, per ½ hour or major part thereof

$ 56.65

A055 Community Medicine Consultation – Office

$ 70.30

C055 Community Medicine Consultation – in-patient

$ 70.30

W055 Community Medicine Consultation – nursing home

$ 70.30

  A405 Community Medicine Limited Consultation-office

$ 54.40

  C405 Community Medicine Limited Consultation – in-patient

$ 54.40

  W405 Community Medicine Limited Consultation – nursing home

$ 54.40

C813 Midwife – Requested Emergency Assessment

$ 54.60

  C815 Midwife-Requested Special Emergency Assessment

$106.95

MRI X499 Three dimensional MRI acquisition sequence

$ 59.80

  X488

X489

Multiple extremities- imaging of two or more joints at one sitting

$104.55

$ 52.25

DIAGNOSTIC & THERAPEUTIC PROCEDURES L829 Hemoglobinopathy interpretation

$ 12.00

L851 Organ or large specimen

$ 69.05

L852 Complex small or large specimen

$110.50

L853 Comprehensive large specimen

$138.10

  E582 When testing with penicillin minor determined mixture outside a hospital setting, add...

$ 10.70

  G174 Dobutamine stress test- when rendered outside of hospital…add

$ 36.65

G192 Video fluoroscopic multichannel urodynamics

$ 68.75

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