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. 

*Please be advised all files distinguished with a 8/15/20 are CMS pending.

• 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 - 8/15/20
• 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) - 8/15/20
• Provider Type 55 Home Based Habilitation Services - 8/15/2020
• Provider Type 57 Adult Residential Care Waiver - 8/15/2020
• Provider Type 58 Waiver for Persons with Physical Disabilities (PD) - 8/15/20
• Provider Type 59 Assisted Living Waiver - 8/15/20
• Provider Type 60 School Based
• Provider Type 64
  
  • Provider Type 64 FFY 16 Reimbursement Rates
  • Provider Type 64 FFY 17 Reimbursement Rates
  • FFY 18 PT 64 Compliant Reimbursement Rates(1)
  • Provider Type 64 FFY 18 Reimbursement Rates - Non-Compliant
  • Provider Type 64 FFY 19 Reimbursement Rates - Compliant
  • Provider Type 64 FFY 19 Reimbursement Rates - Non-Compliant
  • Provider Type 64 FFY 20 Reimbursement Rates - Compliant
  • Provider Type 64 FFY 20 Reimbursement Rates - Non-Compliant
   
• 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