Section 1202 Physician Fee Schedule for Calendar Year 2013
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1 Description Intermediate service $6.33 $6.46 $ Immunization ad $6.33 $6.46 $ Immunization ad, each add $6.33 $6.46 $ Immune ad oral/nasal $6.33 $6.46 $ Immune ad oral/nasal addl $6.33 $6.46 $ Office or OP visit evalu & mgmt of new P $30.95 $31.57 $46.38 Office or OP visit new PT; expanded prob $53.12 $54.18 $78.70 Office or OP visit new PT; low $79.70 $81.30 $ Office or OP visit comprehensive mod $ $ $ Comprehensive visit; high $ $ $ Office or OP visit establ PT phys not RQ $17.02 $17.36 $21.63 Office or OP establ PT 2 of 3 key compon $31.95 $32.58 $46.38 Office or OP visit establ PT low $51.32 complex $52.35 $76.52 Office or OP visit establ PT moder compx $77.10 $78.65 $ Office or OP visit establ PT hgih com $ $ $ Observation care discharge day MGMT $55.29 $56.39 $74.57 Initial observation care per day low com $51.99 $53.03 $ Init observe care per daycomprehen exam $85.44 $87.15 $ Init observe care high $ $ $ Initial hospital care per day low $72.57 $74.03 $ Initial hospital care moderate $99.88 $ $ $ $ $207.89
2 Description $20.48 $20.88 $40.78 $36.34 $37.07 $73.86 $54.35 $55.44 $ Subsequent hospital care low $30.26 $30.86 $40.10 Subsequent hospital care moderate $54.14 $55.22 $73.81 Subsequent hospital care high $77.59 $79.14 $ Eval/mgmt admiss/discharge SDOS $ $ $ Eval/mgmt admiss/discharge moderate severity $ $ $ Eval/mgmt high $ $ $ Hosp discharge day manage 30 or less $55.37 $56.48 $ Hosp discharge manage 1UOS $79.49 = 30 plus $81.08 $ ER dept visit evaluation and mgmt $16.56 $16.89 $ ER dept visit expanded low $31.14 $31.76 $ ER depart visit for E&M of PTmoderate $50.09 $51.09 $ ER dept visit moderate $92.59 $94.45 $ Emergency dept visit $ $ $ Critical care, first hour $ $ $ Critical care, add 30 $95.54 $97.45 $ Nursing facility care, init $65.23 $66.54 $ Nursing facility care, init $90.66 $92.48 $ Nursing facility care, init $ $ $ Nursing fac care, subseq $32.24 $32.89 $ Nursing fac care, subseq $49.55 $50.54 $ Nursing fac care, subseq $66.12 $67.44 $ Nursing fac care, subseq $96.80 $98.74 $139.15
3 Description NF discharge day manage <= 30 NF discharge day manage > 30 $48.13 $49.10 $75.29 $62.85 $64.10 $ Annual nursing fac assessment $68.18 $69.54 $ Domiciliary e/m est patient 15 Domiciliary e/m est patient 25 Domiciliary e/m est patient 40 Domiciliary e/m est patient 60 patient low patient moderate patient moderate patient moderate Home visit eval/mgmt high $45.53 $46.44 $57.31 $66.04 $67.36 $82.37 $ $ $ $ $ $ $ $ $ $45.61 $46.53 $62.36 $70.06 $71.46 $97.52 $99.32 $ $ $ $ $ $47.86 $48.82 $56.95 $66.04 $67.36 $81.60 $ $ $ $ $ $ $ $ $ Home e/m est patient 15 $43.31 $44.17 $ Home e/m est patient 25 $65.12 $66.43 $86.70
4 Description Home e/m est patient 40 $95.06 $96.96 $ Home e/m est patient 60 $ $ $ Prolong service office first hour Prolong service office each add 30 Prolong serv inpatient first hour Prolong serv inpatient each add 30 $76.46 $77.99 $ $75.23 $76.73 $99.99 $69.63 $71.02 $94.22 $69.87 $71.26 $ Phys standby SVC each 30 $55.74 $56.86 $ Anticoag mgmt, init $92.54 $94.39 $ Anticoag mgmt, subseq $31.84 $32.48 $ Init pm e/m, new pat, inf $77.10 $78.65 $ Init pm e/m, new pat 1 4 yrs $83.35 $85.01 $ Prev visit, new, age 5 11 $82.03 $83.68 $ Prev visit, new, age $89.24 $91.03 $ Prev visit, new, age $89.24 $91.03 $ Prev visit, new, age $ $ $ Init pm e/m, new pat 65+ yrs $ $ $ Per pm reeval, est pat, inf $66.06 $67.38 $ Prev visit, est, age 1 4 $73.99 $75.47 $ Prev visit, est, age 5 11 $68.23 $69.60 $ Prev visit, est, age $74.80 $76.29 $ Prev visit, est, age $75.47 $76.98 $ Prev visit, est, age $82.68 $84.33 $ Per pm reeval est pat 65+ yr $92.19 $94.04 $ approx 15 approx 30 approx 45 approx 60 $30.18 $30.78 $38.10 $50.87 $51.88 $64.56 $71.21 $72.63 $89.63 $91.20 $93.02 $115.10
5 Description Behav chng smoking 3 10 $10.12 $10.32 $ Behav chng smoking < 10 $19.67 $20.06 $ Audit/dast, $29.46 $30.05 $ Audit/dast, over 30 $64.26 $65.55 $ Counsel setting approx 30 $2.28 $2.32 $ approx 60 Adist & Interpret health risk asses ins Initial hospital or birthing center care, per day, for of normal newborn infant $15.76 $16.07 $22.69 $10.08 $10.28 $11.90 $55.21 $56.31 $ Initial care, per day, for of normal newborn infant seen in other than hospital or birthing center Subsequent hospital care, per day, for evaluation and management of normal newborn Initial hospital or birthing center care, per day, for of normal newborn infant admitted and discharged on the same date $70.00 $71.40 $ $30.77 $31.38 $42.61 $73.38 $74.85 $ Attendance at delivery (when requested by the delivering physician or other qualified health care professional) and initial stabilization of newborn $64.32 $65.61 $78.54
6 Description Delivery/birthing room resuscitation, provision of positive pressure ventilation and/or chest compressions in the presence of acute inadequate ventilation and/or cardiac output $ $ $ Critical care face to face services, during an interfacility transport of critically ill or critically injured pediatric younger; first utes of hands on care during transport $ $ $ Critical care face to face services, during an interfacility transport of critically ill or critically injured pediatric younger; each additional 30 utes (List separately in addition to code for primary service) $ $ $ Initial inpatient neonatal critical care, per day, for the of a critically ill neonate, 28 days of age or younger $ $ $ Subsequent inpatient neonatal critical care, per day, for the evaluation and management of a critically ill neonate, 28 days of age or younger $ $ $404.52
7 Description Initial inpatient pediatric critical care, per day, for the of a critically ill infant or young child, 29 days through 24 months of age $ $ $ Subsequent inpatient pediatric critical care, per day, for the evaluation and management of a critically ill infant or young child, 29 days through 24 months of age $ $ $ Initial inpatient pediatric critical care, per day, for the of a critically ill infant or $ $ $ young child, 2 through 5 years of age Subsequent inpatient pediatric critical care, per day, for the evaluation and management of a critically ill $ $ $ infant or young child, 2 through 5 years of age Init day hosp neonate care $ $ $ Init day hosp neonate care $ $ $ Init day hosp neonate care $99.64 $ $ Init day hosp neonate care $98.11 $ $ Supervision of interfacility transport care of the critical younger, first 30 utes tbd tbd tbd Supervision of interfacility transport care of the critical younger, each additional 30 utes tbd tbd tbd
NOTE: ALL CPT CODES AND DESCRIPTIONS ARE COPYRIGHTED BY THE AMERICAN MEDICAL ASSOCIATION.
RUN: 04/16/14 11:45:23 DEPARTMENT OF HEALTH AND HOSPITALS - BUREAU OF HEALTH SERVICES - FINANCING PAGE: 1 54 99201 OFFICE,NEW,PROBLEM, STRAIGHTFORWARD 25.78 55 99201 OFFICE,NEW,PROBLEM, STRAIGHTFORWARD
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