SCI-McDuffie Part 4

Effective March 1, 2023

• Physical Therapy  42000029    HC DEVELOPMENTAL TEST EXT PT  $289
• Physical Therapy  42000030    HC HOT OR COLD PACKS THERAPY 1+ AREA      $47
• Physical Therapy  42000049    HC PT ELECTRICAL STIMULATION MANUAL EA 15 MIN   $105
• Physical Therapy  42000050    HC PT SELF CARE/HOME MAN EA 15 MIN  $149
• Physical Therapy  42000051    HC PT ORTHOTICS FITTING/TRAINING    $161
• Physical Therapy  42000052    HC PT WHEELCHAIR MGMT TRAINING      $46
• Physical Therapy  42000053    HC PT TRANSCUTANEOUS NEUROSTIM      $90
• Physical Therapy  42000054    HC PT HEEL WEDGE SMALL  $22
• Physical Therapy  42000061    HC ORTHC/PROSTC MGMT SBSQ ENCOUNTER EACH 15 MIN $117
• Physical Therapy  42000062    HC SELECTIVE WND DEBRIDEMENT EA ADDL 20 CM      $543
• Physical Therapy  42000063    HC PT NON-PHYSICIAN PHONE CALL 5-10 MIN   $23
• Physical Therapy  42000064    HC PT NON-PHYSICIAN PHONE CALL 11-20 MIN  $41
• Physical Therapy  42000065    HC PT NON-PHYSICIAN PHONE CALL 21-30 MIN  $58
• Physical Therapy  42000066    HC PT WORK CONDITIONING(UP TO 2 HRS)      $896
• Physical Therapy  42000067    HC PT WORK CONDITIONING(EA ADD'L HR)      $450
• Physical Therapy  42000068    HC PT UNNA BOOT STRAPPING     $247
• Physical Therapy  42000069    HC PT APPL MULTLAY COMPRS LWR LEG   $247
• Physical Therapy  42000070    HC PT APPL MULTLAY COMPRS ARM/HAND  $247
• Physical Therapy  42000071    HC PT ASSISTIVE TECHNOLOGY ASSESS   $72
• Physical Therapy  42000072    HC PT INFRARED THERAPY 1+ AREAS     $14
• Physical Therapy  42000073    HC PT NDL INSJ W/O NJX 1 OR 2 MUSC  $45
• Physical Therapy  42000074    HC PT NDL INSJ W/O NJX 3+ MUSC      $45
• Physical Therapy  42000075    HC PT CANALITH REPOSITIONING PROC   $41
• Physical Therapy  42400009    HC PT EVAL LOW COMPLEXITY     $228
• Physical Therapy  42400010    HC PT EVAL HIGH COMPLEXITY    $342
• Physical Therapy  42400011    HC EVAL PT LOW COMPLEXITY 3   $228
• Physical Therapy  42400011    HC EVAL PT LOW COMPLEXITY 3   $228
• Physical Therapy  42400012    HC EVAL PT LOW COMPLEXITY 4   $228
• Physical Therapy  42400012    HC EVAL PT LOW COMPLEXITY 4   $228
• Physical Therapy  42400013    HC EVAL PT MOD COMPLEXITY 3   $296
• Physical Therapy  42400014    HC EVAL PT MOD COMPLEXITY 4   $296
• Physical Therapy  42400015    HC EVAL PT HIGH COMPLEXITY 4  $342
• Physical Therapy  42400016    HC EVAL PT HIGH COMPLEXITY 5  $342
• Physical Therapy  42400001    HC EVAL PT LOW COMPLEXITY 2   $228
• Physical Therapy  42400002    HC EVAL PT MOD COMPLEXITY 2   $296
• Physical Therapy  42400003    HC EVAL PT HIGH COMPLEXITY 3  $342
• Physical Therapy  42400004    HC PT REEVAL 2    $296
• Physical Therapy  42400005    HC PT REEVAL 3    $296
• Physical Therapy  42400006    HC PT REEVAL 4    $296
• Physical Therapy  42400007    HC PT EVAL MOD COMPLEXITY     $296
• Physical Therapy  42400008    HC PT RE-EVALUATION     $296
• Occupational Therapy    43000065    HC OT SENSORY INTEGRATION THERAPY   $81
• Occupational Therapy    43000001    HC OT TENS/ESTIM HOME INSTRUCT 15 ONE UNIT CHARGE      $139
• Occupational Therapy    43000002    HC OT TENS/ESTIM HOME INSTRUCT 30 ONE UNIT CHARGE      $274
• Occupational Therapy    43000003    HC OT TENS/ESTIM HOME INSTRUCT 45 ONE UNIT CHARGE      $410
• Occupational Therapy    43000004    HC OT TENS/ESTIM HOME INSTRUCT 60 ONE UNIT CHARGE      $547
• Occupational Therapy    43000005    HC OT IP DEVELOPMENTAL EXT EVAL (45)      $360
• Occupational Therapy    43000007    HC OT HOT/COLD PACK THERAPY 15 MIN  $86
• Occupational Therapy    43000008    HC OT FLUIDOTHERAPY/WHIRLPOOL-15 MIN(1 UNIT CHARGE)     $66
• Occupational Therapy    43000009    HC OT FLUIDOTHERAPY/WHIRLPOOL -30 MIN(1 UNIT CHARGE)     $126
• Occupational Therapy    43000010    HC OT E-STIM OT-15MIN UNITS ATTENDED NMES $89
• Occupational Therapy    43000011    HC OT E-STIM OT-15 MIN W/NEW SET ELECTRODES ATTENDED NMES     $113
• Occupational Therapy    43000012    HC OT IONTOPHORESIS OT 1 SITE (15 MIN)    $77
• Occupational Therapy    43000013    HC OT IONTOPHORESIS OT 2 SITES(15MIN)     $85
• Occupational Therapy    43000014    HC OT IONTOPHORESIS OT 3 SITES(15MIN)     $96
• Occupational Therapy    43000015    HC OT IONTOPHORESIS OT 4 SITES(15MIN)     $108
• Occupational Therapy    43000016    HC OT CONTRAST BATH (PER 15 MIN)    $43
• Occupational Therapy    43000017    HC OT ULTRASOUND OT 15MIN UNITS     $84
• Occupational Therapy    43000018    HC OT ULTRASOUND W/MEDS 15MIN UNITS $96
• Occupational Therapy    43000021    HC OT THERAPEUTIC EXER OT15MIN UNITS NOT W OFF      $123
• Occupational Therapy    43000022    HC OT MANUAL THERAPY 15MIN UNITS NOT W TH AC OFF   $134
• Occupational Therapy    43000023    HC OT THERAPEUTIC GROUP ONE UNIT CHARGE ONLY RX    $123
• Occupational Therapy    43000024    HC OT THERAPEUTIC ACTIVITY OT-15MIN UNITS NOT W SC, MAN THER    $123
• Occupational Therapy    43000025    HC OT SELFCARE/HOME MGT TRAIN-15M UNITS NOT WITH THER ACT     $140
• Occupational Therapy    43000026    HC WORK CONDITIONING(UP TO 2 HRS)   $896
• Occupational Therapy    43000027    HC WORK CONDITIONING(EA ADD'L HR)   $450
• Occupational Therapy    43000028    HC OT FUNCT CAPACITY EVAL 1-25      $185
• Occupational Therapy    43000029    HC OT ORTHO FAB FIT 15MIN UNITS NOT WITH ORTHO CHECK OR THER EX  $117
• Occupational Therapy    43000030    HC OT ORTHO CHECK 15MIN UNITS NOT WITH ORTHO FAB FIT     $117
• Occupational Therapy    43000031    HC OT IMPAIR RATE SPINE $197
• Occupational Therapy    43000032    HC OT IMPAIRMENT RATING 45    $289
• Occupational Therapy    43000033    HC OT IMPAIRMENT RATING 60    $386
• Occupational Therapy    43000034    HC OT IMPAIRMENT RATING 75    $473
• Occupational Therapy    43000035    HC IMPAIRMENT RATING UPPER EXTREMITY      $578
• Occupational Therapy    43000036    HC OT ESTIM UNATTENDED - 1 UNIT CHARGE ONLY TENS  $82
• Occupational Therapy    43000037    HC OT IP DEVELOPMENTAL EXT EVAL-(60)      $360
• Occupational Therapy    43000038    HC OT FUNCT CAPAC EVAL 26+    $185
• Occupational Therapy    43000039    HC OT IMPAIRMENT RATING SPINE $193
• Occupational Therapy    43000040    HC OT IMPAIRMENT RATING 30    $193
• Occupational Therapy    43000041    HC OT IMPAIRMENT RATING 90    $193
• Occupational Therapy    43000042    HC OT PREPLACEMENT SCREENING(EA 15M)      $105
• Occupational Therapy    43000043    HC OT MASTECTOMY THERAPEUTIC EXER OT(15MIN UNITS)      $123
• Occupational Therapy    43000044    HC OT HOT/COLD PACK THERAPY 30 MIN  $84
• Occupational Therapy    43000063    HC OT NEUROMUSCULAR RE-EDUC   $142
• Occupational Therapy    43000064    HC OT COG THER IVNTJ 1ST 15 MIN     $116
• Occupational Therapy    43000066    HC OT NON-PHYSICIAN PHONE CALL 5-10 MIN   $23
• Occupational Therapy    43000067    HC OT NON-PHYSICIAN PHONE CALL 11-20 MIN  $41
• Occupational Therapy    43000068    HC OT NON-PHYSICIAN PHONE CALL 21-30 MIN  $58
• Occupational Therapy    43000069    HC OT UNNA BOOT STRAPPING     $247
• Occupational Therapy    43000070    HC OT APPL MULTLAY COMPRS LWR LEG   $247
• Occupational Therapy    43000071    HC OT APPL MULTLAY COMPRS ARM/HAND  $247
• Occupational Therapy    43000072    HC OT PROSTHETIC TRAINING EA 15 MIN $139
• Occupational Therapy    43000073    HC OT ASSISTIVE TECHNOLOGY ASSESS   $72
• Occupational Therapy    43000074    HC OT WOUND ULTRASOUND  $475
• Occupational Therapy    43000075    HC OT INFRARED THERAPY 1+ AREAS     $14
• Occupational Therapy    43000076    HC OT WHEELCHAIR MGMT TRAINING      $46
• Occupational Therapy    43000077    HC OT VASOPNEUMATIC DEVICE    $147
• Occupational Therapy    43000078    HC OT NDL INSJ W/O NJX 1 OR 2 MUSC  $45
• Occupational Therapy    43000079    HC OT NDL INSJ W/O NJX 3+ MUSC      $45
• Occupational Therapy    43400018    HC OT EVAL 4 HIGH COMPLEXITY  $342
• Occupational Therapy    43400019    HC OT EVAL 5 HIGH COMPLEXITY  $342
• Occupational Therapy    43400020    HC OT EVAL 6 HIGH COMPLEXITY  $342
• Occupational Therapy    43400021    HC OT EVAL 7 HIGH COMPLEXITY  $342
• Occupational Therapy    43400022    HC OT EVAL 8 HIGH COMPLEXITY  $342
• Occupational Therapy    43400023    HC OT EVAL LOW COMPLEXITY     $228
• Occupational Therapy    43400024    HC OT EVAL HIGH COMPLEXITY    $342
• Occupational Therapy    43400025    HC OT EVAL 4 LOW COMPLEXITY   $228
• Occupational Therapy    43400026    HC OT EVAL 5 LOW COMPLEXITY   $228
• Occupational Therapy    43400027    HC OT EVAL 6 LOW COMPLEXITY   $228
• Occupational Therapy    43400001    HC OT EVAL 2 MOD COMPLEXITY   $296
• Occupational Therapy    43400002    HC OT EVAL 3 MOD COMPLEXITY   $296
• Occupational Therapy    43400003    HC OT EVAL 4 MOD COMPLEXITY   $296
• Occupational Therapy    43400004    HC OT EVAL 5 MOD COMPLEXITY   $296
• Occupational Therapy    43400005    HC OT EVAL 6 MOD COMPLEXITY   $296
• Occupational Therapy    43400006    HC OT 2 REEVALUATION    $296
• Occupational Therapy    43400007    HC OT 3 REEVALUATION    $296
• Occupational Therapy    43400008    HC OT 4 REEVALUATION    $296
• Occupational Therapy    43400009    HC OT 6 REEVALUATION    $296
• Occupational Therapy    43400010    HC OT EVAL 2 LOW COMPLEXITY   $228
• Occupational Therapy    43400011    HC OT EVAL 3 LOW COMPLEXITY   $228
• Occupational Therapy    43400012    HC OT 5 REEVALUATION    $296
• Occupational Therapy    43400013    HC OT EVAL 1 LOW COMPLEXITY   $228
• Occupational Therapy    43400014    HC OT EVAL 7 MOD COMPLEXITY   $296
• Occupational Therapy    43400015    HC OT EVAL 8 MOD COMPLEXITY   $296
• Occupational Therapy    43400016    HC OT EVAL MOD COMPLEXITY     $296
• Occupational Therapy    43400017    HC OT RE-EVALUATION     $296
• Speech Therapy    44000077    HC SWALLOW/ORAL FEEDING THERAPY     $432
• Speech Therapy    44000078    HC  EVAL ORAL/PHAR SWALLOW    $343
• Speech Therapy    44000079    HC MOTION FLOUROSCOPY SWALLOW $517
• Audiology   44000001    HC AUD REHAB POSTLING HEAR LOSS     $180
• Audiology   44000002    HC AUD REHAB PRE-LING HEAR LOSS     $180
• Audiology   44000003    HC AUDITORY FUNCTION ADDTL 15 MIN   $86
• Audiology   44000004    HC EVAL AUD REHAB STATUS      $267
• Audiology   44000005    HC EVAL AUD STATUS EA ADDL 15 MIN   $88
• Speech Therapy    44000006    HC FEEDING THERAPY - 1  $217
• Speech Therapy    44000007    HC FEEDING THERAPY - 2  $217
• Speech Therapy    44000008    HC FEEDING THERAPY - 3  $217
• Speech Therapy    44000009    HC FEEDING THERAPY - 4  $431
• Speech Therapy    44000010    HC FEEDING THERAPY - 5  $431
• Speech Therapy    44000011    HC FEEDING THERAPY - 6  $641
• Speech Therapy    44000012    HC FEEDING THERAPY - 7  $641
• Speech Therapy    44000013    HC MOD-VOICE PROTHESIS  $308
• Speech Therapy    44000014    HC NEONATAL INTERVENTION - 1  $217
• Speech Therapy    44000015    HC NEONATAL INTERVENTION - 2  $217
• Speech Therapy    44000016    HC NEONATAL INTERVENTION - 3  $217
• Speech Therapy    44000017    HC NEONATAL INTERVENTION - 4  $431
• Speech Therapy    44000018    HC NEONATAL INTERVENTION - 5  $431
• Speech Therapy    44000019    HC NEONATAL INTERVENTION - 6  $641
• Speech Therapy    44000020    HC NEONATAL INTERVENTION - 7  $641
• Speech Therapy    44000021    HC SENSORY INTEGRATIVE TECHNIQUES   $88
• Speech Therapy    44000021    HC SENSORY INTEGRATIVE TECHNIQUES   $88
• Speech Therapy    44000022    HC SENSORY INTEGRATION EA 15M $97
• Speech Therapy    44000023    HC SPEECH THERAPY - 1   $220
• Speech Therapy    44000024    HC SPEECH THERAPY - 2   $220
• Speech Therapy    44000025    HC SPEECH THERAPY - 3   $220
• Speech Therapy    44000026    HC SPEECH THERAPY - 4   $435
• Speech Therapy    44000027    HC SPEECH THERAPY - 5   $435
• Speech Therapy    44000028    HC SPEECH THERAPY - 6   $649
• Speech Therapy    44000029    HC SPEECH THERAPY - 7   $649
• Speech Therapy    44000030    HC SPEECH THERAPY - 8   $867
• Speech Therapy    44000032    HC SWALLOW THER VITALSTIM BRIEF     $254
• Speech Therapy    44000033    HC SWALLOW THER VITALSTIM STANDARD  $506
• Speech Therapy    44000034    HC SWALLOWING THERAPY - 1     $217
• Speech Therapy    44000035    HC SWALLOWING THERAPY - 2     $217
• Speech Therapy    44000036    HC SWALLOWING THERAPY - 3     $217
• Speech Therapy    44000037    HC SWALLOWING THERAPY - 4     $431
• Speech Therapy    44000038    HC SWALLOWING THERAPY - 5     $431
• Speech Therapy    44000039    HC SWALLOWING THERAPY - 6     $641
• Speech Therapy    44000040    HC SWALLOWING THERAPY - 7     $641
• Speech Therapy    44000042    HC VIDEO FLUORO SWAL EVAL     $779
• Speech Therapy    44000067    HC SP EVAL VOICE 1      $301
• Speech Therapy    44000068    HC SP EVAL VOICE 2      $301
• Speech Therapy    44000069    HC SP EVAL VOICE 3      $301
• Speech Therapy    44000070    HC SP EVAL VOICE 4      $439
• Speech Therapy    44000071    HC SP EVAL VOICE 5      $439
• Speech Therapy    44000072    HC SP EVAL VOICE 6      $655
• Speech Therapy    44000073    HC SP EVAL VOICE 7      $655
• Speech Therapy    44000074    HC SP EVAL VOICE 8      $655
• Speech Therapy    44000075    HC SP EVAL VOICE 9      $655
• Speech Therapy    44000076    HC SPEECH DISORDER IND  $378
• Speech Therapy    44000080    HC STANDARD COGNITIVE PERFORM TESTING 1HR $439
• Speech Therapy    44000081    HC SLP NON-PHYSICIAN PHONE CALL 5-10 MIN  $23
• Speech Therapy    44000082    HC SLP NON-PHYSICIAN PHONE CALL 11-20 MIN $41
• Speech Therapy    44000083    HC SLP NON-PHYSICIAN PHONE CALL 21-30 MIN $58
• Speech Therapy    44000084    HC SP COG THER IVNTJ 1ST 15 MIN     $111
• Speech Therapy    44000085    HC SP COG THER IVNTJ EA ADDL 15 MIN $111
• Speech Therapy    44100001    HC INFANT STIMULATION   $169
• Speech Therapy    44300001    HC SPEECH DEVELOPMENT GROUP 1 $220
• Speech Therapy    44300002    HC SPEECH DEVELOPMENT GROUP 2 $220
• Speech Therapy    44300003    HC SPEECH DEVELOPMENT GROUP 3 $220
• Speech Therapy    44300004    HC SPEECH DEVELOPMENT GROUP 4 $435
• Speech Therapy    44300005    HC SPCH DEVEL DELAY STIMUL GROUP    $149
• Speech Therapy    44400081    HC EVALUATION OF SPEECH FLUENCY     $224
• Speech Therapy    44400082    HC EVALUATE SPEECH PRODUCTION $224
• Speech Therapy    44400083    HC SPEECH SOUND LANG COMPREHEN      $431
• Speech Therapy    44400084    HC BEHAVRAL QUALIT ANALYS VOICE     $224
• Speech Therapy    44400085    HC EVAL SPEECH,VOICE,COMM     $753
• Speech Therapy    44400001    HC AUG/ALT COMM - 1     $212
• Speech Therapy    44400002    HC AUG/ALT COMM - 2     $212
• Speech Therapy    44400003    HC AUG/ALT COMM - 3     $212
• Speech Therapy    44400004    HC AUG/ALT COMM - 4     $421
• Speech Therapy    44400005    HC AUG/ALT COMM - 5     $421
• Speech Therapy    44400006    HC AUG/ALT COMM - 6     $629
• Speech Therapy    44400007    HC AUG/ALT COMM - 7     $629
• Speech Therapy    44400008    HC AUG/ALT COMM EVAL - 1      $302
• Speech Therapy    44400009    HC AUG/ALT COMM EVAL - 2      $302
• Speech Therapy    44400010    HC AUG/ALT COMM EVAL - 3      $302
• Speech Therapy    44400011    HC AUG/ALT COMM EVAL - 4      $421
• Speech Therapy    44400015    HC EVAL/FIT OP VOICE PROTHESIS      $412
• Speech Therapy    44400016    HC FEEDING EVAL - 1     $292
• Speech Therapy    44400017    HC FEEDING EVAL - 2     $292
• Speech Therapy    44400018    HC FEEDING EVAL - 3     $292
• Speech Therapy    44400019    HC FEEDING EVAL - 4     $572
• Speech Therapy    44400020    HC FEEDING EVAL - 5     $572
• Speech Therapy    44400021    HC FEEDING EVAL - 6     $851
• Speech Therapy    44400022    HC FEEDING EVAL - 7     $851
• Speech Therapy    44400023    HC FEEDING EVAL - 8     $1,133
• Speech Therapy    44400024    HC FEEDING EVAL - 9     $1,133
• Speech Therapy    44400025    HC NEONATAL ASSESSMENT - 1    $292
• Speech Therapy    44400026    HC NEONATAL ASSESSMENT - 2    $292
• Speech Therapy    44400027    HC NEONATAL ASSESSMENT - 3    $292
• Speech Therapy    44400028    HC NEONATAL ASSESSMENT - 4    $572
• Speech Therapy    44400029    HC NEONATAL ASSESSMENT - 5    $572
• Speech Therapy    44400030    HC NEONATAL ASSESSMENT - 6    $851
• Speech Therapy    44400031    HC NEONATAL ASSESSMENT - 7    $851
• Speech Therapy    44400032    HC NEONATAL ASSESSMENT - 8    $1,133
• Speech Therapy    44400033    HC NEONATAL ASSESSMENT - 9    $1,133
• Speech Therapy    44400034    HC PRE-FLUORO SWAL EVAL - 1   $292
• Speech Therapy    44400035    HC PRE FLUORO SWAL EVAL - 2   $292
• Speech Therapy    44400036    HC PRE-FLUORO SWAL EVAL - 3   $292
• Speech Therapy    44400037    HC PRE FLUORO SWAL EVAL - 4   $572
• Speech Therapy    44400038    HC PRE-FLUORO SWAL EVAL - 5   $572
• Speech Therapy    44400041    HC SPEECH EVAL - 1      $224
• Speech Therapy    44400042    HC SPEECH EVAL - 2      $224
• Speech Therapy    44400043    HC SPEECH EVAL - 3      $224
• Speech Therapy    44400044    HC SPEECH EVAL - 4      $431
• Speech Therapy    44400045    HC SPEECH EVAL - 5      $431
• Speech Therapy    44400046    HC SPEECH EVAL - 6      $641
• Speech Therapy    44400047    HC SPEECH EVAL - 7      $641
• Speech Therapy    44400048    HC SPEECH EVAL - 8      $855
• Speech Therapy    44400049    HC SPEECH EVAL - 9      $855
• Speech Therapy    44400052    HC AUG/ALT COMM EVAL EA ADD 30MIN   $74
• Speech Therapy    44400053    HC SP EVAL FLUENCY 1    $301
• Speech Therapy    44400054    HC SP EVAL FLUENCY 2    $301
• Speech Therapy    44400055    HC SP EVAL FLUENCY 3    $301
• Speech Therapy    44400056    HC SP EVAL FLUENCY 4    $439
• Speech Therapy    44400057    HC SP EVAL FLUENCY 5    $439
• Speech Therapy    44400058    HC SP EVAL FLUENCY 6    $655
• Speech Therapy    44400059    HC SP EVAL FLUENCY 7    $655
• Speech Therapy    44400060    HC SP EVAL FLUENCY 8    $871
• Speech Therapy    44400061    HC SP EVAL FLUENCY 9    $871
• Speech Therapy    44400062    HC SP EVAL SOUND PROD 1 $301
• Speech Therapy    44400063    HC SP EVAL SOUND PROD 2 $301
• Speech Therapy    44400064    HC SP EVAL SOUND PROD 3 $301
• Speech Therapy    44400065    HC SP EVAL SOUND PROD 4 $439
• Speech Therapy    44400066    HC SP EVAL SOUND PROD 5 $439
• Speech Therapy    44400067    HC SP EVAL SOUND PROD 6 $655
• Speech Therapy    44400068    HC SP EVAL SOUND PROD 7 $655
• Speech Therapy    44400069    HC SP EVAL SOUND PROD 8 $871
• Speech Therapy    44400070    HC SP EVAL SOUND PROD 9 $871
• Speech Therapy    44400071    HC SP EVAL LANG 1 $301
• Speech Therapy    44400072    HC SP EVAL LANG 2 $301
• Speech Therapy    44400073    HC SP EVAL LANG 3 $301
• Speech Therapy    44400074    HC SP EVAL LANG 4 $439
• Speech Therapy    44400075    HC SP EVAL LANG 5 $439
• Speech Therapy    44400076    HC SP EVAL LANG 6 $655
• Speech Therapy    44400077    HC SP EVAL LANG 7 $655
• Speech Therapy    44400078    HC SP EVAL LANG 8 $871
• Speech Therapy    44400080    HC SP EVAL LANG 9 $871
• Speech Therapy    44400086    HC ASSESSMENT OF APHASIA 1HR  $200
• Speech Therapy    44400087    HC DEVELOPMENTAL TESTING, EXTENDED  $234
• Emergency   45000001    HC ER LEVEL 1     $331
• Emergency   45000002    HC ER LEVEL 2     $397
• Emergency   45000003    HC ER LEVEL 3     $579
• Emergency   45000004    HC ER LEVEL 4     $1,213
• Emergency   45000005    HC ER LEVEL 5     $1,588
• Emergency   45000007    HC THERAPEUTIC INTRA-ARTERIAL INJ   $224
• Emergency   45000008    HC ER LEVEL LIMITED     $119
• Emergency   45000019    HC ER CRITICAL CARE     $3,675
• Emergency   45000020    HC ER LEVEL VI EA ADD 30 MIN  $559
• Emergency   45000021    HC LEVEL IV PROCEDURE ED PSYCH HOLD
• Pulmonary Rehab   46000031    HC PULM REHAB EDUCATION ASSISTANCE  $41
• Pulmonary Rehab   46000001    HC SPIROMETRY     $215
• Pulmonary Rehab   46000002    HC ADULT SPIROMETRY FULL MEASURE    $228
• Pulmonary Rehab   46000003    HC SINGLE-SPIROMETRY-PFT      $417
• Pulmonary Rehab   46000004    HC BRONCHOSPASM EVALUATION    $228
• Pulmonary Rehab   46000005    HC SPIROMETRY- B AND A BRONCHODIL   $875
• Pulmonary Rehab   46000006    HC BRONCHIAL CHALLENGE  $1,025
• Pulmonary Rehab   46000007    HC MAXIMUM BREATHING CAPACITY $250
• Pulmonary Rehab   46000010    HC NITROGEN LUNG VOLUMES      $266
• Pulmonary Rehab   46000011    HC HIGH ALTITUDE SIM    $178
• Pulmonary Rehab   46000012    HC HIGH ALTITUDE SIM WITH OXYGEN    $178
• Pulmonary Rehab   46000013    HC N/N SURFACTANT ADMINISTRATION    $208
• Pulmonary Rehab   46000014    HC 6 MINUTE WALK  $203
• Pulmonary Rehab   46000015    HC PULMONARY STRESS TEST - SIMPLE   $203
• Pulmonary Rehab   46000016    HC PULMONARY STRESS TEST-COMPLEX    $986
• Pulmonary Rehab   46000017    HC CLOSED SYSTEM O2-INCL CO2 AND    $362
• Pulmonary Rehab   46000018    HC CALORIMETRY-O2 UPTAKE INDIRECT   $894
• Pulmonary Rehab   46000019    HC DLCO-DIFFUSION- PL   $595
• Pulmonary Rehab   46000020    HC OXYGEN SATURATION    $46
• Pulmonary Rehab   46000022    HC OXIMETER N200 MULTIPLE ER  $139
• Pulmonary Rehab   46000023    HC SLEEP OXIMETRY STUDY $672
• Pulmonary Rehab   46000025    HC PULMONARY REHAB PHASE II MOD     $41
• Pulmonary Rehab   46000026    HC PULM FUNCT TEST PLETHYSMOGRAPY   $724
• Pulmonary Rehab   46000027    HC FLOW VOLUME LOOP     $417
• Pulmonary Rehab   46000030    HC PULSE OX O2 DESAT STUDY ADULT    $132
• Audiology   47000001    HC OTOACOUSTIC EMISSIONS-SCREEN     $176
• Audiology   47000002    HC REPRGRAM COCHLEAR IMPLANT >7YR   $230
• Audiology   47000004    HC AUD REHAB PRE-LING HEAR LOSS     $176
• Audiology   47000005    HC AUD REHAB POSTLING HEAR LOSS     $176
• Audiology   47100008    HC SCREENING-PURE TONE AIR ONLY     $77
• Audiology   47100009    HC AIR CONDUCTION AUDIOGRAM   $123
• Audiology   47100010    HC AIR AND BONE COND AUDIOGRAM      $181
• Audiology   47100011    HC SPEECH RECEPTION THRESHOLD $109
• Audiology   47100012    HC SPEECH DISCRIMINATION      $161
• Audiology   47100013    HC COMPLETE AUDIOGRAM   $329
• Audiology   47100014    HC TYMPANOMETRY   $151
• Audiology   47100015    HC ACOUSTIC REFLEX      $109
• Audiology   47100016    HC VISUAL AUDIOMETRY(VRA)     $197
• Audiology   47100018    HC AEP THRSHOLD EST MLT FREQ I&R    $1,453
• Audiology   47100020    HC AEP NEURODIAGNOSTIC BRAINSTEM I&R      $1,453
• Audiology   47100021    HC AEP SCR NEONATE HEARING TEST     $410
• Audiology   47100022    HC AEP HEARING STATUS DETER I&R     $1,453
• Audiology   47100023    HC OTOACOUSTIC EMISS'N-DIAGNOSTIC   $359
• Audiology   47100024    HC ANALYSIS COCHLEAR IMPLANT <7YR   $378
• Audiology   47100025    HC REPRGRAM COCHLEAR IMPLANT <7YR   $230
• Audiology   47100026    HC ANALYSIS COCHLEAR IMPLANT >7YR   $378
• Audiology   47100027    HC CENTRAL AUDITORY FUNCTION SCAN   $346
• Audiology   47100028    HC STENGER PURE TONE    $70
• Audiology   47100029    HC ACOUSTIC IMMITTANCE TESTING      $70
• Audiology   47100030    HC STENGER SPEECH TEST  $262
• Audiology   47100031    HC CONDITIONING PLAY AUDIOMETRY     $185
• Audiology   47100032    HC SELECT PICTURE AUDIOMETRY  $70
• Audiology   47100033    HC HEARING AID EXAM BOTH EARS $176
• Audiology   47100034    HC AUDIOLOGY CONSULT PER 15 MIN     $86
• Audiology   47100035    HC TINNITUS ASSESSMENT  $185
• Audiology   47100036    HC AUDITORY FUNCTION ADDTL 15 MIN   $86
• Audiology   47100037    HC EVAL AUD REHAB STATUS      $262
• Audiology   47100038    HC EVAL AUD STATUS EA ADDL 15 MIN   $86
• Device Clinic     48000081    HC PROG EVAL IN PERSON LEADLESS PM  $63
• Device Clinic     48000082    HC INTERROG DEVICE EVAL IN PERSON LEADLESS PM   $63
• Device Clinic     48000084    HC IMPLT SUBQ DEFIB INTEROGATION    $266
• Device Clinic     48000085    HC IMPLT SUBQ DEFIB SYS DEVICE EVAL $266
• Heart Failure Clinic    48000086    HC AHFC REMOTE ICM <= 30 DAYS $180
• Heart Failure Clinic    48000087    HC HEART FAILURE FLUID MONITORING   $180
• Cath Lab    48000088    HC INTRAOP TEE    $4,112
• Device Clinic     48000089    HC PROGRAM DEVICE EVAL PPM LEADLS IN PERSON     $290
• Cath Lab    48000090    HC PERIPROCEDURAL EVAL PPM LEADLS   $62
• Device Clinic     48000091    HC INTERROGATION DEVICE EVAL PPM LEADLS   $290
• Device Clinic     36000719    HC IMPLT SUBQ DEFIB INTEROGAT $266
• Device Clinic     36000720    HC IMPLT SUBQ DEFIB SYS DEV EVL     $266
• Device Clinic     48000002    HC TEMPORARY PACING TRANSCUTANEOUS  $1,663
• Device Clinic     48000005    HC MICROVOLT T-WAVE ALTERNANS $487
• Device Clinic     48000006    HC ELEC ANALY PACE W/REPRO/SINGLE   $290
• Device Clinic     48000007    HC ELEC ANALY PACER W/REPROG/DUAL   $321
• Device Clinic     48000008    HC ELEC ANALY AICD/SING/W/REPROG    $236
• Device Clinic     48000009    HC ELEC ANALY AICD/DUAL/W/REPROG    $266
• Device Clinic     48000010    HC ELEC ANALY AICD/MULT/W/REPROG    $266
• Device Clinic     48000011    HC ELECTRONIC ANALYSIS LOOP (ILR)   $721
• Device Clinic     48000012    HC PM DEVICE INTERROGATION    $236
• Device Clinic     48000013    HC ICD DEVICE INTERROGATION   $180
• Cardiac Diagnostics     48000014    HC ECHO CONGENITAL ANOMALIES COMPLETE      $2,538
• Cardiac Diagnostics     48000015    HC ECHO CONGENITAL ANOMALIES LIMITED      $888
• Cardiac Diagnostics     48000016    HC ECHOCARDIOGRAM COMPLETE    $2,307
• Cardiac Diagnostics     48000017    HC ECHOCARDIOGRAM 2D ONLY     $923
• Cardiac Diagnostics     48000018    HC ECHOCARDOGRAM LIMITED STUDY      $888
• Cardiac Diagnostics     48000019    HC TRANSESOPHAGEAL ECHOCARDIOGRAM   $1,701
• Cardiac Diagnostics     48000020    HC CARDIAC PULSED WAVE DOPPLER      $809
• Cardiac Diagnostics     48000021    HC COLOR FLOW MAPPING   $809
• Cardiac Diagnostics     48000022    HC STRESS ECHO COMPLETE $2,535
• Cardiac Diagnostics     48000023    HC DILUTION STUDY W/CARDIAC OTPUT   $140
• Cardiac Diagnostics     48000029    HC EP FOLLOW-UP   $6,003
• Cardiac Diagnostics     48000030    HC EVAL/CARDIO-DEFIB LEADS;INTRAO   $2,357
• Cardiac Diagnostics     48000038    HC BLOOD PRESSURE MONITORING 24HR   $637
• Cardiac Diagnostics     48000039    HC BLOOD PRESSURE ANALYSIS/REPORT   $221
• Cardiac Diagnostics     48000040    HC ASPIRATION THROMBECTOMY    $5,590
• Cardiac Diagnostics     48000041    HC TEE INCOMPLETE $1,239
• Cardiac Diagnostics     48000042    HC TEE WITH CONTRAST    $1,827
• Cardiac Diagnostics     48000043    HC TTE COMPLETE WITH CONTRAST $2,819
• Cardiac Diagnostics     48000044    HC ECHOCARDIOGRAM COMPLETE    $2,307
• Cardiac Diagnostics     48000045    HC ECHOCARDIOGRAM 2D ONLY     $923
• Cardiac Diagnostics     48000046    HC ECHOCARDOGRAM LIMITED STUDY      $888
• Cardiac Diagnostics     48000047    HC CARDIAC PULSED WAVE DOPPLER      $809
• Cardiac Diagnostics     48000048    HC COLOR FLOW MAPPING   $809
• Cardiac Diagnostics     48000049    HC TTE COMPLETE WITH CONTRAST $2,819
• Cardiac Diagnostics     48000051    HC TTE COMPLETE WITH CONTRAST $2,819
• Cardiac Diagnostics     48000053    HC ECHOCARDOGRAM LIMITED STUDY      $888
• Cardiac Diagnostics     48000054    HC PM PHONE DEVICE EVAL=<90 DAYS    $180
• Cardiac Diagnostics     48000055    HC PM/ICD REMOTE TECH SERV =<90 DAYS      $180
• Cardiac Diagnostics     48000056    HC ICM/ILR REMOTE TECH SERV =<30 DAYS     $180
• Cardiac Diagnostics     48000057    HC ICM DEVICE EVAL PER PT ENCOUNTER $180
• Cardiac Diagnostics     48000059    HC ELEC ANALY AICD/MULT/W/REPROG    $266
• Cardiac Diagnostics     48000061    HC EVAL/CARDIO-DEFIB LEADS;INTRAO   $2,357
• Device Clinic     48000062    HC PM DEVICE INTERROGATION    $236
• Device Clinic     48000063    HC ICD DEVICE INTERROGATION   $180
• Cath Lab    48000065    HC INTRACARD ECHO DURING INTERVEN   $5,974
• Device Clinic     48000067    HC PRE-OP PM DEVICE EVAL      $180
• Device Clinic     48000068    HC PRE-OP ICD DEVICE EVAL     $180
• Device Clinic     48000069    HC ILR DEVICE INTERROGATE     $180
• Device Clinic     48000070    HC WCD DEVICE INTERROGATE     $180
• Device Clinic     48000071    HC ELEC ANALY AICD/SING/W/REPROG    $236
• Device Clinic     48000072    HC EVAL/CARD-DEFIB W/TEST,P/GEN     $3,011
• Device Clinic     48000073    HC ELEC ANALY PACE W/REPRO/SINGLE   $290
• Device Clinic     48000074    HC ELEC ANALY PACER W/REPROG/DUAL   $321
• Device Clinic     48000075    HC ELEC ANALY AICD/DUAL/W/REPROG    $236
• Device Clinic     48000076    HC ELECTRONIC ANALYSIS LOOP (ILR)   $721
• Device Clinic     48000077    HC PM DEVICE INTERROGATION    $236
• Device Clinic     48000078    HC ICD DEVICE INTERROGATION   $180
• Device Clinic     48000079    HC ELEC ANALY AICD/SING/W/REPROG    $236
• Device Clinic     48000080    HC ELEC ANALY AICD/MULT/W/REPROG    $266
• Device Clinic     48000083    HC INTERROGATION VAD IN PERSON      $392
• Device Clinic     48000092    HC REM INTERROG EVL PM/LDLS PM      $58
• Device Clinic     48000093    HC REM INTERROG EVL PO/IDS    $70
• Device Clinic     48000094    HC STRESS TTE ONLY      $867
• Device Clinic     48000095    HC TTE W OR W/O FOL W/CON STRESS    $3,672
• Device Clinic     48000096    HC TTE W OR W/O CONT ECG      $3,672
• Device Clinic     48000097    HC DOPPLER ECHO: LIMITED/F-UP $539
• Device Clinic     48000099    HC TTE LIMITED W CONTRAST     $729
• Device Clinic     48000100    HC REM INTERROG DEV EVAL ICPMS <30 D      $180
• Device Clinic     48000101    HC REM INTERROG DEV EVAL SCRMS <30 D      $180
• Device Clinic     48000102    HC MYOCRD STRAIN IMG SPCKL TRCK     $203
• Device Clinic     48000103    HC COR FFR DATA PREP & TRANMIS      $270
• Device Clinic     48000104    HC COR FFR ALYS GNRJ FFR MDL  $3,780
• Cath Lab    48000105    HC PB VALVULOPLASTY; MITRAL VALVE   $17,528
• Cath Lab    48100082    HC CARDIOVERSION ELECTIVE, INTERNAL $1,234
• Cath Lab    48100083    HC IMPLANT PRESSURE SENSOR W/ANGIO (CARDIOMEMS) $50,085
• Cath Lab    48100084    HC ENDOMYOCARDIAL BIOPSY      $4,097
• Cath Lab    48100085    HC TCAT INSERT/REPLACE PERM LDLS PM $25,638
• Cath Lab    48100086    HC TCAT REMOVAL PPM LDLS (MICRA)    $4,095
• Cath Lab    48000003    HC CARDIOVERSION/ELECTIVE/EXTERNAL  $1,234
• Cath Lab    48000004    HC CORONARY ULTRASOUND, INITIAL     $5,447
• Cath Lab    48000024    HC DOPPL VELO/ PRES COR FLOW MEAS   $5,447
• Cath Lab    48000025    HC PRES FLOW MEAS EA ADD'L VESSEL   $5,447
• Cath Lab    48000026    HC INTRAVENTRICULAR PACING (RV)     $6,618
• Cath Lab    48000027    HC 3 DIMENSION MAPPING  $8,911
• Cath Lab    48000028    HC COM EP EVAL W/LT ATRIAL RECORD   $9,836
• Cath Lab    48000031    HC EVAL/CARD-DEFIB W/TEST,P/GEN     $3,433
• Cath Lab    48000032    HC EP EVAL/CARDIOVERTER-DEFIB $2,869
• Cath Lab    48000033    HC ABLATION OF AV NODE FUNCTION     $12,343
• Cath Lab    48000036    HC TILT TABLE EVALUATION      $1,359
• Cath Lab    48000037    HC INTRACARD ECHO DURING INTERVEN   $5,974
• Cath Lab    48000050    HC CDU CARDIOVERSION/ELECTIVE/EXTERNAL    $1,234
• Cath Lab    48000052    HC CARDIOVERSION/ELECTIVE/EXTERNAL  $1,234
• Cath Lab    48000058    HC CARDIOVERSION/ELECTIVE/EXTERNAL  $1,234
• Cath Lab    48000066    HC PM DEVICE PROGR EVAL MULTI $236
• Cath Lab    48100001    HC THROMBECTOMY   $4,903
• Cath Lab    48100002    HC BRACHYTHERAPY CATHETER PLACEME   $7,020
• Cath Lab    48100003    HC LEFT HRT W/THROMBOLYTICS USED    $1,604
• Cath Lab    48100004    HC INTRACOR IV INFUSION W/THROMBOLYSIS    $408
• Cath Lab    48100005    HC ADD'L VESSEL CORONARY U/S  $5,447
• Cath Lab    48100010    HC VALVULOPLASTY AORTIC $8,217
• Cath Lab    48100013    HC TEE      $1,701
• Cath Lab    48100014    HC RIGHT HEART CATH     $5,547
• Cath Lab    48100015    HC LEFT HRT CATH W/VENTRCLGRPHY     $5,801
• Cath Lab    48100016    HC R&L HRT CATH W/VENTRICLGRPHY     $6,735
• Cath Lab    48100017    HC CORONARY ARTERY ANGIO S&I  $5,812
• Cath Lab    48100018    HC CORONARY ART/GRFT ANGIO S&I      $6,149
• Cath Lab    48100019    HC R HRT CORONARY ARTERY ANGIO      $6,066
• Cath Lab    48100020    HC R HRT ART/GRFT ANGIO $6,403
• Cath Lab    48100021    HC L HRT ARTERY/VENTRICLE ANGIO     $6,066
• Cath Lab    48100022    HC L HRT ART/GRFT ANGIO $6,403
• Cath Lab    48100023    HC R & L HRT CATH WINJX HRT ART& L VENTR IMG   $7,000
• Cath Lab    48100024    HC R& L HRT CATH W/INJEC HRT ART/GRFT& L VENT I $7,337
• Cath Lab    48100025    HC L HRT CATH TRNSPTL PUNCTURE      $5,900
• Cath Lab    48100026    HC DRUG ADMIN DURING CARD CATH      $383
• Cath Lab    48100027    HC SWANZ-GANZ     $2,550
• Cath Lab    48100028    HC CORONARIES ONLY      $126
• Cath Lab    48100029    HC INJECTION INTERNAL GRAFTS  $170
• Cath Lab    48100029    HC INJECTION INTERNAL GRAFTS  $170
• Cath Lab    48100030    HC INJ LEFT VENTRI OR ATRIAL  $115
• Cath Lab    48100031    HC INJ RIGHT VENTRI OR ATRIAL $115
• Cath Lab    48100032    HC ROOT SHOT - AORTOGRAM      $111
• Cath Lab    48100033    HC INJECTION-PULMONARY ANGIOGRAPH   $144
• Cath Lab    48100034    HC BUNDLE OF HIS RECORDING    $8,911
• Cath Lab    48100035    HC INTRA-ATRIAL RECORDING     $8,911
• Cath Lab    48100036    HC RT VENTRICULAR RECORDING   $8,911
• Cath Lab    48100037    HC MAPPING OF TACHYCARDIA SITES     $8,911
• Cath Lab    48100038    HC INTRA-ATRIAL PACING  $8,911
• Cath Lab    48100039    HC ESOPHAGEAL RECORDING $8,911
• Cath Lab    48100040    HC ESOPHAGEAL RECORDING W/PACING    $8,911
• Cath Lab    48100041    HC INDUCTION OF ARRHYTHMIA    $8,911
• Cath Lab    48100042    HC COMPREHENSIVE EP EVALUATION      $9,836
• Cath Lab    48100043    HC COMP EP EVAL W/INDUCT ARRHYTHM   $9,836
• Cath Lab    48100044    HC COMP EP EVAL W/VENTRIC RECORD    $9,836
• Cath Lab    48100044    HC COMP EP EVAL W/VENTRIC RECORD    $9,836
• Cath Lab    48100045    HC STIM/PACING AFTER IV DRUG INFU   $8,911
• Cath Lab    48100046    HC EVAL CARD DEFIB TEST PULSE GEN   $3,433
• Cath Lab    48100047    HC OCCLUSIVE DEV PLACEMENT OF $1,235
• Cath Lab    48100049    HC NONSEL ILIAC ANGIOGRM W/LT HRT   $1,234
• Cath Lab    48100052    HC RT HRT TRANSSEPTAL LT HRT CATH   $5,900
• Cath Lab    48100053    HC INJECTION PULMONARY ANGIOGRAPH   $144
• Cath Lab    48100054    HC INJECTION PULMONARY ANGIOGRAPH   $144
• Cath Lab    48100055    HC PRQ CARDIAC ANGIOPLAST 1 ART     $9,503
• Cath Lab    48100056    HC PRQ CARDIAC ANGIO ADDL ART $9,503
• Cath Lab    48100057    HC PRQ CARD ANGIO/ATHRECT 1 ART     $16,914
• Cath Lab    48100058    HC PRQ CARD ANGIO/ATHRECT ADDL      $16,914
• Cath Lab    48100059    HC PRQ CARD STENT W/ANGIO 1 VSL     $16,914
• Cath Lab    48100060    HC PRQ CARD STENT W/ANGIO ADDL      $16,914
• Cath Lab    48100061    HC PRQ CARD STENT/ATH/ANGIO   $16,914
• Cath Lab    48100062    HC PRQ TRLUML CORONARY STENT/ATH/ANGIO ADDL BRANCH      $16,914
• Cath Lab    48100063    HC PRQ REVASC BYP GRAFT 1 VSL $16,914
• Cath Lab    48100064    HC PRQ REVASC BYP GRAFT ADDL  $16,914
• Cath Lab    48100065    HC PRQ CARD REVASC MI 1 VSL   $16,914
• Cath Lab    48100066    HC PRQ CARD REVASC CHRONIC 1VSL     $16,914
• Cath Lab    48100067    HC PRQ CARD REVASC CHRONIC ADDL     $16,914
• Cath Lab    48100068    HC EP & ABLATE SUPRAVENT ARRHYT     $37,742
• Cath Lab    48100069    HC EP & ABLATE VENTRIC TACHY $37,742
• Cath Lab    48100070    HC ABLATE ARRHYTHMIA ADD ON   $12,343
• Cath Lab    48100071    HC TX ATRIAL FIB PULM VEIN ISOL     $37,742
• Cath Lab    48100072    HC TX L/R ATRIAL FIB ADDL     $12,343
• Cath Lab    48100073    HC PERC DRUG-EL COR STENT SING      $16,914
• Cath Lab    48100074    HC PERC DRUG-EL COR STENT BRAN      $16,914
• Cath Lab    48100075    HC PERC D-E COR STENT ATHER S       $25,637
• Cath Lab    48100076    HC PERC D-E COR STENT ATHER BR      $25,637
• Cath Lab    48100077    HC PERC D-E COR REVASC T CABG S     $16,914
• Cath Lab    48100078    HC PERC D-E COR REVASC T CABG B     $16,914
• Cath Lab    48100079    HC PERC D-E COR REVASC W AMI S      $25,637
• Cath Lab    48100080    HC PERC D-E COR REVASC CHRO SIN     $25,637
• Cath Lab    48100081    HC PERC D-E CORREVASC CHRO ADD      $25,637
• Stress Test 48200001    HC CARDIOVASCULAR STRESS TEST $1,121
• Stress Test 48200003    HC CVP CARDIOVASCULAR STRESS TEST   $1,121
• Cardiac Diagnostics     48300001    HC ECHO LTD/FOLLOW-UP W/ CONTRAST   $1,227
• Cardiac Diagnostics     48300002    HC 2D TTE W OR W/O FOL W/CON COMPLETE      $1,688
• Cardiac Diagnostics     48300003    HC TTE W OR WO CONTRAST CONT ECG    $3,672
• Stress Test 48200004    HC CARDIOVASCULAR STRESS TEST $986
• General Outpatient Clinic     51000003    HC EVALUATION AND MANAGEMENT NEW PATIENT LEVEL 2 EXPANDED  $192
• General Outpatient Clinic     51000005    HC EVALUATION AND MANAGEMENT NEW PATIENT LEVEL 3 DETAILED  $216
• General Outpatient Clinic     51000007    HC EVALUATION AND MANAGEMENT NEW PATIENT LEVEL 4 COMPREHENSIVE   $239
• General Outpatient Clinic     51000009    HC EVALUATION AND MANAGEMENT NEW PATIENT LEVEL 5 COMPLEX   $261
• General Outpatient Clinic     51000010    HC EVALUATION AND MANAGEMENT ESTABLISHED PATIENT LEVEL 1 BRIEF   $171
• General Outpatient Clinic     51000012    HC EVALUATION AND MANAGEMENT ESTABLISHED PATIENT LEVEL 2 EXPANDED      $192
• General Outpatient Clinic     51000015    HC EVALUATION AND MANAGEMENT ESTABLISHED PATIENT LEVEL 3 DETAILED      $216
• General Outpatient Clinic     51000017    HC EVALUATION AND MANAGEMENT ESTABLISHED PATIENT LEVEL 4 COMPREHENSIVE $239
• General Outpatient Clinic     51000019    HC EVALUATION AND MANAGEMENT ESTABLISHED PATIENT LEVEL 5 COMPLEX $261
• General Outpatient Clinic     51000021    HC ASTHMA/COPD/TB EDUCATION INITIAL $212

See Part 5