FEE SCHEDULES

The information contained in these schedules is made available to provide information and is not a guarantee by the State or the Department or its employees as to the present accuracy of the information contained herein. 

*The rate schedules with an "*" include the 6% FFS rate reductions as approved in AB3 of the 2020 Special Legislative Session. These reductions have been submitted to CMS for review and are pending approval. Once approval is received, the fee schedule will be updated with only the revised rates and the corresponding effective date. 

• Hospital Rates and Revenue Codes *
• Provider Type 10 Outpatient Surgery-ASC Procedures and Payment Groups  
• Provider Type 12 Outpatient Hospital*
• Provider Type 14 Behavioral Health Outpatient Treatment* 
• Provider Type 15 Registered Dietitian and Medical Nutrition Therapy*  
• Provider Type 17
  • Specialty 166, Special Clinic, Family Planning*
  • Specialty 169, Special Clinic, Obstetrical Care Clinic, Birthing Centers * 
  • Specialty 171, Special Clinic Methadone *
  • Specialty 174, Special Clinic, Public Health* 
  • Specialty 179, School Based Health Centers *
  • Specialty 183, Comprehensive Outpatient Rehab Facilities *
  • Specialty 195, Special Clinic, Community Health *
  • Specialty 196, Special Clinic, Early Intervention *
  • Specialty 198, Special Clinic, HIV *
  • Specialty 215, Substance Abuse Agency Model (SAAM)*                                                   
   
• Provider Type 20 Physician, MD., Osteopath *
• Provider Type 21 Podiatrists *
• Provider Type 22 Dentists *
• Provider Type 23 Hearing Aid Dispenser & Supplies *
• Provider Type 24 Advanced Practice Registered Nurse *
• Provider Type 25 Optometrist *
• Provider Type 26 Psychologist *
• Provider Type 27 Radiology *
• Provider Type 29 Home Health Agency - 8/15/20*
• Provider Type 30 and 83 Personal Care Services - 8/15/20*
• Provider Type 32
  • Provider Type 32 Ambulance, Spec 249 Comm Paramed  *
  • Provider Type 32 Ambulance, Spec 932 Ambulance Air or Ground  *
   

• Provider Type 33 Durable Medical Equipment, Prosthetics, Orthotics & Supplies *
• Provider Type 34 Therapy *
• Provider Type 36 Chiropractor *
• Provider Type 38 Waiver for Individuals with Intellectual Disabilities and Related Conditions (ID) *
• Provider Type 39 Adult Day Health Center  *
• Provider Type 41 Optician, Optical Business *
• Provider Type 43 Laboratory, Pathology Clinical *
• Provider Type 45 and 81 End Stage Renal Disease *
• Provider Type 48 Waiver for the Frail Elderly (FE) - 12/01/20 *
• Provider Type 55 Home Based Habilitation Services  *
• Provider Type 57 Adult Residential Care Waiver - 12/01/2020 *
• Provider Type 58 Waiver for Persons with Physical Disabilities (PD) - 12/01/20 *
• Provider Type 59 Assisted Living Waiver - 12/01/20 *
• Provider Type 60 School Based *
• Provider Type 64 
  • Provider Type 64 FFY 20 Reimbursement Rates - Compliant
  • Provider Type 64 FFY 20 Reimbursement Rates - Non-Compliant
  • Provider Type 64 FFY 21 Reimbursement Rates - Compliant - Updated 11/23
  • Provider Type 64 FFY 21 Reimbursement Rates - Non-Compliant - Updated 11/23
   
• Provider Type 72 Nurse Anesthetist *
• Provider Type 74 Nurse Midwife *
• Provider Type 76 Audiologist *
• Provider Type 77 Physician Assistant *
• Provider Type 82 Rehabilitative Behavioral Health *
• Provider Type 85 Applied Behavioral Analysis Fee Schedule *