Foster Care Article 29-I Other Limited Health Services Schedule Summary

Jul 23

  • Schedule also available in Portable Document Format (PDF)
Service Description Rate Code Unit Upstate Downstate Statewide (where applicable)
Alcohol and /or Drug Screening, Testing, Treatment 4588 15 min $40.10 $47.85 N/A
Developmental Test Administration 4589 15 min $29.59 $35.32 N/A
Psychotherapy (Individual and Family) 4590 15 min $33.91 $40.46 N/A
Psychotherapy Group 4591 15 min $11.75 $13.05 N/A
Neuropsychological Testing/Evaluation Services 4592 15 min $32.89 $39.25 N/A
Psychiatric Diagnostic Examination 4593 15 min $49.33 $58.86 N/A
Office Visit 4594 15 min $48.74 $63.67 N/A
Smoking Cessation treatment 4595 15 min $18.13 $21.62 N/A
ECG 4596 Per occurrence N/A N/A $15.15
Screening - Developmental/Emotional/Behavioral 4597 Per occurrence $59.67 $71.21 N/A
Hearing and Evaluation of Speech 4598 15 min N/A N/A $8.37
Immunization (Administration) 4599 Per occurrence N/A N/A $18.03
Lab: Lithium 4600 Per Laboratory Procedure N/A N/A $8.08
Lab: Urinalysis, by dip stick or tablet reagent Lab: Urinalysis, by dip stick or tablet reagent Lab: Urinalysis; Bacterium scree, except B 4671 Per Laboratory Procedure N/A N/A $2.02
Infectious agent antigen detection by immunoassay technique (e.g., enzyme immunoassay [EIA], enzyme-linked immunosorbent assay [ELISA], immunochemiluminometric assay [IMCA]), qualitative or semiquantitative, multiple-step method; severe acute respiratory syndrome coronavirus (e.g., SARS-CoV, SARS-CoV-2 [COVID19]) 4672 Per Laboratory Procedure N/A N/A $45.68
Interpreter Services 4673 Per occurrence N/A N/A $11.11
Lab: Urine pregnancy test, by visual color comparison methods 4674 Per Laboratory Procedure N/A N/A $2.02
Lab: Hemoglobin; glycosylated (A1C) 4675 Per Laboratory Procedure N/A N/A $11.11
Blood count; Hemoglobin (HGB) 4676 Per Laboratory Procedure N/A N/A $2.02
Lab: Antibody; HIV-1 4677 Per Laboratory Procedure N/A N/A $11.11
Lab: Smear, primary source with Interpretation 4678 Per Laboratory Procedure N/A N/A $4.04
Lab: Infectious agent detection by nucleic ac 4679 Per Laboratory Procedure N/A N/A $97.97
Lab: Infectious agent detection by immunoassay 4680 Per Laboratory Procedure N/A N/A $4.04
Lab: Infectious agent antigen detection by IM (Influenza rapid test) 4681 Per Laboratory Procedure N/A N/A $15.15
Lab: Molecular PCR Test 4682 Per Laboratory Procedure N/A N/A $51.82
COVID-19 Specimen Collection (can be reimbursed if specimen collection is a standalone service not associated with an office visit or a COVID-19 Molecular PCR test). 4683 Per Laboratory Procedure N/A N/A $23.69
Tuberculosis (TB) tests 4684 Per Laboratory Procedure N/A N/A $5.05
Medical Nutritional Therapy Service 4685 15 min $26.36 $31.52  
Child and Family Treatment and Support Services Refer to the Children's HCBS Billing Guidance webpage.
Home and Community Based Services Refer to the Children's HCBS Billing Guidance webpage.